Finger systolic pressure during local cooling in normal subjects aged 20 to 60 years: reference values for the assessment of digital vasospasm in Raynaud's phenomenon of occupational origin

1988 ◽  
Vol 61 (3) ◽  
pp. 179-181 ◽  
Author(s):  
Massimo Bovenzi
Keyword(s):  
Reference Values ◽  
Raynaud’S Phenomenon ◽  
Systolic Pressure ◽  
Normal Subjects ◽  
Raynaud's Phenomenon ◽  
Local Cooling ◽  
Finger Systolic Pressure

scholarly journals Infrared Thermography as a Method of Verification in Raynaud’s Phenomenon

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 981
Author(s):  
Lotte Lindberg ◽  
Bent Kristensen ◽  
Ebbe Eldrup ◽  
Jane Frølund Thomsen ◽  
Lars Thorbjørn Jensen
Keyword(s):  
Diagnostic Test ◽  
Sensitivity And Specificity ◽  
Raynaud’S Phenomenon ◽  
Systolic Pressure ◽  
Target Population ◽  
Raynaud's Phenomenon ◽  
Local Cooling ◽  
Thermographic Imaging ◽  
Alternative Algorithm ◽  
Finger Systolic Pressure

Raynaud’s phenomenon (RP) is characterized by the episodic whitening of the fingers upon exposure to cold. A recently described thermographic algorithm was proposed as a diagnostic replacement of the currently applied finger systolic pressure (FSP) test. The aim of the study was to evaluate the performance of the thermographic algorithm when applied in patients suspected of having RP. Forty-three patients were examined using thermographic imaging after local cooling of the hands in water of 10 °C for 1 min. The thermographic algorithm was applied to predict the probability of RP. The performance of the algorithm was evaluated with different cut-off levels. A new algorithm was proposed based on patients from the target population. The performance of the tested algorithm was noninferior to the FSP test, when a cut-off level of 0.05 was applied, yielding a sensitivity and specificity of 69% and 58%, respectively. The accuracy was 66%. The FSP test had a sensitivity and specificity of 77% and 37%, respectively, and the accuracy was 59%. The thermographic method proved useful for detecting RP and was able to replace the FSP test as a diagnostic test. The alternative algorithm revealed that other thermographic variables were more predictive of the target population, but this should be verified in future patients.

Effect of cold pressor test on single-breath DLCO in normal subjects

1994 ◽  
Vol 76 (2) ◽  
pp. 750-755 ◽  
Author(s):  
A. Frans ◽  
E. Lampert ◽  
O. Kallay ◽  
B. Nejadnik ◽  
C. Veriter ◽  
...  
Keyword(s):  
Pulmonary Arterial Pressure ◽  
Raynaud’S Phenomenon ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Normal Subjects ◽  
Raynaud's Phenomenon ◽  
Pulmonary Wedge Pressure ◽  
Single Breath ◽  
Pulmonary Arterial ◽  
Wedge Pressure

We hypothesized that the decrease in single-breath diffusing capacity of CO (DLCO) as observed in patients with Raynaud's phenomenon (P.J. Fahey et al. Am. J. Med. 76:263–269, 1984) may be present in normal subjects. Therefore, we examined 31 healthy subjects in two different laboratories. Two series of experiments were performed. In the first series DLCO was measured in 22 volunteers before (twice) and 5, 10, and 30 min after a cold pressor test (CPT), which consisted of immersing both hands in a 12 degrees C water bath for 2 min. In the second series right heart catheterization was performed in nine healthy seated subjects. Cardiac output, mean pulmonary arterial pressure, heart rate, and pulmonary wedge pressure were measured before, during, and 10, 20, and 30 min after the CPT. In every volunteer the CPT induced a decrease in DLCO that was still present 30 min after the test. In the nine catheterized subjects DLCO increased above control values during the CPT and then decreased below control values for 30 min. The CPT had no effect on cardiac output, heart rate, or pulmonary wedge pressure. In contrast, pulmonary arterial pressure and pulmonary vascular resistance increased during the CPT and then became lower than the control values for at least 30 min. In summary, the CPT induced a biphasic evolution of DLCO in normal subjects, being increased during the CPT and decreased after it. Our data are best explained by the West model of the lung. Our data suggest that the pulmonary Raynaud's phenomenon is not specific to patients with primary Raynaud's phenomenon.(ABSTRACT TRUNCATED AT 250 WORDS)

Impaired transient vasodilation and increased vasoconstriction to digital local cooling in primary Raynaud's phenomenon

2011 ◽  
Vol 301 (2) ◽  
pp. H324-H330 ◽  
Author(s):  
Matthieu Roustit ◽  
Sophie Blaise ◽  
Claire Millet ◽  
Jean-Luc Cracowski
Keyword(s):  
Blood Flow ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Topical Anesthesia ◽  
Sensory Nerves ◽  
Local Cooling ◽  
Doppler Flowmetry ◽  
Percentage Decrease ◽  
Significant Difference ◽  
And Gender

Raynaud's phenomenon (RP) is defined as episodic ischemia of the extremities in response to cold. Although the structure of skin capillaries is normal in primary RP, some data suggest impairment of microvascular function. We aimed at testing whether digital skin blood flow was lower in RP than in controls while cooling locally. We further evaluated the contribution of sensory nerves in the response. We recruited 21 patients with primary RP and 20 healthy volunteers matched on age and gender. After a 10-min baseline at 33°C, skin temperature was cooled at 15 or 24°C during 30 min on the forearm and the finger while monitoring perfusion with a custom-design laser Doppler flowmetry probe. Perfusion was also assessed after topical anesthesia. Blood flow was expressed as cutaneous vascular conductance (CVC). Data were subsequently expressed as area above the curve (AAC0–30) of the percentage decrease from baseline CVC (%BL). CVC on the dorsum of the finger was lower in RP patients compared with controls at 15°C (AAC0–30 were 106,237.2 and 69,544.3%BL·s, respectively; P = 0.02) and at 24°C (AAC0–30 were 86,915 and 57,598%BL·s, respectively; P = 0.04) whereas we observed no significant difference on the finger pad and the forearm. Topical anesthesia increased CVC in patients with RP ( P = 0.05), whereas it did not affect reactivity in controls ( P = 0.86). Our study shows exaggerated skin microvascular vasoconstriction to local cooling on the dorsum of the finger in primary RP compared with controls. Part of this abnormal response in primary RP depends on sensitive nerves.

Analysis of rewarming curves in Raynaud’s phenomenon of various aetiologies

2009 ◽  
Vol 34 (5) ◽  
pp. 621-626 ◽  
Author(s):  
K. M. SALEM ◽  
M. BAKER ◽  
R. M. HILLIAM ◽  
S. DAVIES ◽  
C. DEIGHTON ◽  
...  
Keyword(s):  
Raynaud’S Phenomenon ◽  
Provocation Test ◽  
Normal Subjects ◽  
Raynaud's Phenomenon ◽  
Finger Temperature ◽  
Independent Verification ◽  
Cold Provocation Test ◽  
Medical Reports ◽  
Baseline Temperature ◽  
Cold Provocation

This study investigated whether a modified Cold Provocation Test could distinguish between 86 normal subjects and 31 patients with Raynaud’s phenomenon or 59 with hand arm vibration syndrome (HAVS). Of the HAVS subjects, 56 were seen for medical reports as they were involved in litigation. Their assessments were done in a different location but the same protocol was used. A standardised cold stress was used to reduce the finger temperature to 15°C or less without inducing reflex hyperaemia. This test had acceptable repeatability for subjects without HAVS with an intra-class correlation of 0.7. Baseline temperature, temperature rise in the first 30 seconds and the time taken to rewarm by 5°C were measured. Patients with Raynaud’s phenomenon and HAVS had cooler hands than controls. HAVS patients rewarmed most in the first 30 seconds. Patients with Raynaud’s phenomenon take longer to rewarm by 5°C than controls or those with HAVS ( P<0.001). A baseline difference of >7.5°C between the temperature of the digit and that of the room is unlikely to occur in patients with Raynaud’s phenomenon or HAVS. A temperature gain of ≥2.2°C in the first 30 seconds on rewarming combined with a low baseline temperature strongly suggests HAVS. This modified cold provocation test may differentiate between patients with Raynaud’s phenomenon, HAVS and controls but this observation requires independent verification in subjects not involved in litigation and tested in the same facility.

scholarly journals “Beet” the cold: beetroot juice supplementation improves peripheral blood flow, endothelial function, and anti-inflammatory status in individuals with Raynaud’s phenomenon

2019 ◽  
Vol 127 (5) ◽  
pp. 1478-1490 ◽  
Author(s):  
Anthony I. Shepherd ◽  
Joseph T. Costello ◽  
Stephen J. Bailey ◽  
Nicolette Bishop ◽  
Alex J. Wadley ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Endothelial Function ◽  
Diastolic Blood Pressure ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Beetroot Juice ◽  
Local Cooling ◽  
Inflammatory Status ◽  
Anti Inflammatory

Raynaud’s phenomenon (RP) is characterized by recurrent transient peripheral vasospasm and lower nitric oxide (NO) bioavailability in the cold. We investigated the effect of nitrate-rich beetroot juice (BJ) supplementation on 1) NO-mediated vasodilation, 2) cutaneous vascular conductance (CVC) and skin temperature (Tsk) following local cooling, and 3) systemic anti-inflammatory status. Following baseline testing, 23 individuals with RP attended four times, in a double-blind, randomized crossover design, following acute and chronic (14 days) BJ and nitrate-depleted beetroot juice (NDBJ) supplementation. Peripheral Tsk and CVC were measured during and after mild hand and foot cooling, and during transdermal delivery of acetylcholine and sodium nitroprusside. Markers of anti-inflammatory status were also measured. Plasma nitrite concentration ([nitrite]) was increased in the BJ conditions ( P < 0.001). Compared with the baseline visit, thumb CVC was greater following chronic-BJ (Δ2.0 flux/mmHg, P = 0.02) and chronic-NDBJ (Δ1.45 flux/mmHg, P = 0.01) supplementation; however, no changes in Tsk were observed ( P > 0.05). Plasma [interleukin-10] was greater, pan endothelin and systolic and diastolic blood pressure (BP) were reduced, and forearm endothelial function was improved, by both BJ and NDBJ supplementation ( P < 0.05). Acute and chronic BJ and NDBJ supplementation improved anti-inflammatory status, endothelial function and blood pressure (BP). CVC following cooling increased post chronic-BJ and chronic-NDBJ supplementation, but no effect on Tsk was observed. The key findings are that beetroot supplementation improves thumb blood flow, improves endothelial function and anti-inflammatory status, and reduces BP in people with Raynaud’s. NEW & NOTEWORTHY This is the first study to examine the effect of dietary nitrate supplementation in individuals with Raynaud’s phenomenon. The principal novel findings from this study were that both beetroot juice and nitrate-depleted beetroot juice 1) increased blood flow in the thumb following a cold challenge; 2) enhanced endothelium-dependent and -independent vasodilation in the forearm; 3) reduced systolic and diastolic blood pressure, and pan-endothelin concentration; and 4) improved inflammatory status in comparison to baseline.

scholarly journals Migraine In Systemic Lupus Erythematosus in Rheumatological outpatients unit

2019 ◽  
Vol 13 (1) ◽  
pp. 51-55
Author(s):  
Ameer Shaker
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Raynaud’S Phenomenon ◽  
Normal Subjects ◽  
Raynaud's Phenomenon ◽  
Cross Sectional Study ◽  
High Rate ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Cardiolipin Antibodies

Background: Migraine is common in systemic lupus erythematosus.It is a significant source of patient disability. Objective: To determine the rate of migraine in patients with systemic lupus erythematosus, to assess migraine type, severity, and the association between migraine and patient’s characteristics. Type of the study: Cross-sectional study. Methods: 100 subjected were recruited and divided into two groups; fifty patients with the diagnosis of systemic lupus erythematosus were recruited from the Rheumatologic department of medicine,and another 50 normal subjects, then complete medical and drugs history were taken from them. Results: Fifty patients completed the questionnaire. Thirty percent of systemic lupus erythematosus patients and 12% of normal subjects had migraine. Of the patients with migraine 80%, 13.3% and 6.7% met criteria for migraine without aura, migraine with aura and retinal migraine respectively. The moderately severe migraine was commonly observed (53.3%). There were significant associations between migraine and systemic lupus erythematosus patients who have Raynaud’s phenomenon, and cardiolipin antibodies.There were no statistically significant associations between migraine, systemic lupus erythematosus duration and patient’s age,sex, and anti-dsDNA. Conclusions:A high rate of migraine in patients with systemic lupus erythematosus.Migraine associated with Raynaud’s phenomenon, and cardiolipin antibodies.

scholarly journals Characteristic Features of Infrared Thermographic Imaging in Primary Raynaud’s Phenomenon

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 558
Author(s):  
Lotte Lindberg ◽  
Bent Kristensen ◽  
Jane F. Thomsen ◽  
Ebbe Eldrup ◽  
Lars T. Jensen
Keyword(s):  
Raynaud’S Phenomenon ◽  
Area Under The Curve ◽  
Raynaud's Phenomenon ◽  
Great Promise ◽  
Healthy Controls ◽  
Local Cooling ◽  
Predictive Values ◽  
Verification Method ◽  
Thermographic Imaging ◽  
Characteristic Features

Raynaud’s phenomenon (RP) is characterized by the episodic whitening of the fingers upon exposure to cold. Verification of the condition is crucial in vibration-exposed patients. The current verification method is outdated, but thermographic imaging seems promising as a diagnostic replacement. By investigating patients diagnosed with RP, the study aimed at developing a simple thermographic procedure that could be applied to future patients where verification of the diagnosis is needed. Twenty-two patients with primary RP and 58 healthy controls were examined using thermographic imaging after local cooling of the hands for 1 min in water of 10°C. A logistic regression model was fitted with the temperature curve characteristics to convey a predicted probability of having RP. The characteristics time to end temperature and baseline temperature were the most appropriate predictors of RP among those examined (p = 0.004 and p = 0.04, respectively). The area under the curve was 0.91. The cut-off level 0.46 yielded a sensitivity and specificity of 82% and 86%, respectively. The positive and negative predictive values were 69% and 93%, respectively. This newly developed thermographic method was able to distinguish between patients with RP and healthy controls and was easy to operate. Thus, the method showed great promise as a method for verification of RP in future patients. Trial registration: ClinicalTrials.gov NCT03094910.

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