Application of a novel finger temperature device in the assessment of subjects with Raynaud's phenomenon

2021 ◽  
Author(s):  
Teodor Aleksiev ◽  
Zlatina Ivanova ◽  
Hristo Dobrev ◽  
Nikolay Atanasov
Keyword(s):  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Finger Temperature

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 Successful Treatment of Digital Ulcers in a Scleroderma Patient with Continuous Bilateral Thoracic Sympathetic Block

2008 ◽  
Vol 1;11 (1;1) ◽  
pp. 91-96
Author(s):  
Chan Kim
Keyword(s):  
Continuous Infusion ◽  
Conservative Therapy ◽  
Raynaud’S Phenomenon ◽  
Treatment Options ◽  
Raynaud's Phenomenon ◽  
Digital Ulcers ◽  
Sympathetic Block ◽  
Finger Temperature ◽  
Scleroderma Patient ◽  
The Right

Background: Raynaud’s phenomenon (RP) associated with connective tissue disease (secondary RP) may be difficult to manage with conservative therapy. A combination of sympathetically mediated vasospasm and vaso-occlusion has been implicated as the etiology of digital ischemic phenomenon. Thoracic sympathetic outflow blocking has been performed with various techniques. However, there have been some limitations in all treatment options. Objective: We report on a patient with medically refractory digital ulceration and gangrene caused by scleroderma who was successfully treated with a continuous infusion of mepivacaine into the thoracic sympathetic ganglions as a means to improve finger circulation. Case Report: We are reporting on a 32-year-old female patient suffering from a medically intractable gangrenous ulcer in the right third finger and the left second and third fingers, accompanied by aching pain (VAS, visual analogue scale, 5 – 6/10) and numbness in both forearms. She underwent continuous infusion of mepivacaine through the thoracic sympathetic catheter placed in T2 vertebral segment for 13 days on the right and for 11 days on the left and cervical epidural infusion of mepivcaine with fentanyl for 10 days after the medical treatment failed. Her finger temperature increased 2o C – 5o C during the thoracic sympathetic block with continuous infusion of mepivacine. Her finger wounds healed completely with 13 days of the continuous thoracic sympathetic block without any complications. Conclusions: Continuous infusion of mepivacaine into the thoracic sympathetic ganglionic space led to the healing of the medically refractory gangrenous ulcer of the fingers in the patient with scleroderma. Key words: Scleroderma, Raynaud’s phenomenon, thoracic sympathetic catheter

scholarly journals Proximal heat stress up-regulates angiopoietin-1 in fingers and reduces the severity of Raynaud’s phenomenon in systemic sclerosis: a single-centre pilot study

2021 ◽  
Author(s):  
Yoshihito Shima ◽  
Akane Watanabe ◽  
Nobuto Inoue ◽  
Tetsuya Maruyama ◽  
Eiji Kunitomo ◽  
...  
Keyword(s):  
Blood Flow ◽  
Systemic Sclerosis ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Body Parts ◽  
Heating Period ◽  
Related Factors ◽  
Finger Temperature ◽  
Pre Treatment ◽  
Angiopoietin 1

ABSTRACT Objectives Raynaud’s phenomenon (RP) is a peripheral vascular disorder that frequently occurs in systemic sclerosis (SSc). Although therapeutic heating seems reasonable given that RP is elicited by cold stimuli, the effects of heating are still unclear. We examined the effects of heating applied on various body parts in SSc patients with RP of fingers. Methods Fourteen SSc patients heated their neck, elbows, and wrists with disposable heating pads for 1 week each. The visual analogue scale (VAS) for RP during each heating period was compared with that of each 1-week pre-treatment interval. On the day after the expiration of each heating period, their finger temperature, the finger blood flow, and angiogenesis-related factors (vascular endothelial growth factor, endostatin, angiopoietin-1, and angiopoietin-2) obtained from the cubital vein and fingertip were measured. Results The mean VAS was significantly reduced during the heating of the neck and elbows. Fingertip blood samples showed significantly increased angiopoietin-1 after each of the heating periods and increased endostatin after wrist heating. After the termination of heating, changes in finger temperature or blood flow could not be detected. Conclusions Heating the neck or elbows can alleviate RP in SSc. The heat up-regulates angiopoietin-1 in the fingers.

Ascorbic Acid does not Improve Endothelium-Dependent Flow-mediated Dilatation of the Brachial Artery in Patients with Raynaud’s Phenomenon Secondary to Systemic Sclerosis

2003 ◽  
Vol 73 (1) ◽  
pp. 3-7 ◽  
Author(s):  
M. E. Mavrikakis ◽  
J. P. Lekakis ◽  
M. Papamichael ◽  
K. S. Stamatelopoulos ◽  
Ch. C. Kostopoulos ◽  
...  
Keyword(s):  
Ascorbic Acid ◽  
Smooth Muscle ◽  
Systemic Sclerosis ◽  
Endothelial Dysfunction ◽  
Brachial Artery ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Water Soluble ◽  
Placebo Administration ◽  
Flow Mediated Dilatation

Previous studies have shown that patients with Raynaud’s phenomenon secondary to systemic sclerosis present abnormal endothelial function; the mechanisms responsible for the endothelial dysfunction are unknown but increased vascular oxidative stress could be a possible cause. The hypothesis that a potent water-soluble antioxidant can reverse endothelial dysfunction in these patients was tested in the present study. We examined 11 female patients with Raynaud’s phenomenon secondary to systemic sclerosis and ten healthy control women by ultrasound imaging of the brachial artery to assess flow-mediated (endothelium-dependent) and nitrate-induced (endothelium-independent) vasodilatation. Flow-mediated dilatation and nitrate-induced dilatation were significantly reduced in patients with Raynaud’s phenomenon, indicating abnormal endothelial and smooth muscle cell function. Patients with Raynaud’s phenomenon entered a double-blind, randomized, crossover placebo-controlled trial and received orally 2 g of ascorbic acid or placebo; vascular studies were repeated two hours after ascorbic acid or placebo administration. Flow-mediated dilatation did not improve after ascorbic acid (1.6 ± 2.2% to 2.2 ± 2.5%, ns) or placebo administration (1.2 ± 1,9% to 1.7 ± 1.4%, ns); also nitrate-induced dilatation was similar after ascorbic acid or placebo (16 ± 7.4% vs 17 ± 8%, ns), suggesting no effect of ascorbic acid on endothelial and vascular smooth muscle function. In conclusion, ascorbic acid does not reverse endothelial vasomotor dysfunction in the brachial circulation of patients with Raynaud’s phenomenon secondary to systemic sclerosis. The use of different antioxidants or different dosing of ascorbic acid may be required to show a beneficial effect on endothelial vasodilator function.

The response of skin perfusion and of rheological and immunological variables to intravenous prostanoid administration in Raynaud’s phenomenon secondary to collagenosis

VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 243-249 ◽  
Author(s):  
Drinda ◽  
Neumann ◽  
Pöhlmann ◽  
Vogelsang ◽  
Stein ◽  
...  
Keyword(s):  
Laser Doppler Flowmetry ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Plasma Viscosity ◽  
Laser Doppler ◽  
Erythrocyte Aggregation ◽  
Control Group ◽  
Long Term Effects ◽  
Doppler Flowmetry

Background: Prostanoids are used in the treatment of Raynaud’s phenomenon and acral perfusion disorders secondary to collagenosis. In subjective terms, intravenous administration of these agents produces success in more than 50% of patients. The therapeutic outcome of clinical administration of alprostadil or iloprost may vary from individual to individual. Patients and methods: The following variables were analysed in a cross-over study in 27 patients with collagenosis and Raynaud’s phenomenon: plasma viscosity and erythrocyte aggregation (rheological variables), partial pressure of oxygen and laser Doppler flowmetry in the finger region, and lymphocyte phenotyping and interleukin (IL) determinations (immunological variables). Results: Laser Doppler flowmetry revealed significant differences between patients with secondary Raynaud’s phenomenon and a control group of 25 healthy subjects. Laser Doppler readings did not change significantly as a result of the treatments. Therapy with iloprost produced a reduction in IL-1beta, L-selectin (CD 62 L) and IL-6. Conclusion: The change in immunological variables due to iloprost may explain the long-term effects of prostaglandins in the treatment of Raynaud’s phenomenon. From our results it is not possible to infer any preference for iloprost or alprostadil.

Raynaud’s phenomenon and digital ischaemia - pharmacologic approach and alternative treatment options

VASA ◽  
2016 ◽  
Vol 45 (3) ◽  
pp. 201-212 ◽  
Author(s):  
Birgit Linnemann ◽  
Matthias Erbe
Keyword(s):  
Quality Of Life ◽  
Angiotensin Receptor Blockers ◽  
Raynaud’S Phenomenon ◽  
Treatment Options ◽  
Raynaud's Phenomenon ◽  
Tissue Loss ◽  
Receptor Antagonists ◽  
Skin Ulcers ◽  
Digital Ischaemia

Abstract. The primary goal of therapy is to reduce the frequency and intensity of Raynaud’s attacks and to minimize the related morbidity rather than to cure the underlying condition. Treatment strategies depend on whether Raynaud’s phenomenon (RP) is primary or secondary. All patients should be instructed about general measures to maintain body warmth and to avoid triggers of RP attacks. Pharmacologic intervention can be useful for patients with severe and frequent RP episodes that impair the patient’s quality of life. Calcium channel blockers are currently the most prescribed and studied medications for this purpose. There has been limited evidence for the efficacy of alpha-1-adrenergic receptor antagonists, angiotensin receptor blockers, topical nitrates or fluoxetine to treat RP. The intravenously administered prostacyclin analogue iloprost can reduce the frequency and severity of RP attacks and is considered a second-line therapy in patients with markedly impaired quality of life, critical digital ischaemia and skin ulcers who are at risk for substantial tissue loss and amputation. Phosphodiesterase inhibitors (e.g., sildenafil) can also improve RP symptoms and ulcer healing whereas endothelin-1 receptor antagonists (e.g., bosentan) are mainly considered treatment options in secondary prevention for patients with digital skin ulcers related to systemic sclerosis. However, their use in clinical practice has been limited by their high cost. Antiplatelet therapy with low-dose aspirin is recommended for all patients who suffer from secondary RP due to ischaemia caused by structural vessel damage. Anticoagulant therapy can be considered during the acute phase of digital ischaemia in patients with suspected vascular occlusive disease attributed to the occurrence of new thromboses. In patients with critical digital ischaemia, consideration should be given to hospitalisation, optimisation of medical treatment in accordance with the underlying disease and evaluation for a secondary, possibly reversible process that is causing or aggravating the clinical symptoms.

You’re the Flight Surgeon

2020 ◽  
Vol 91 (5) ◽  
pp. 459-461
Keyword(s):  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Vibration Syndrome

Warneke JA, Pavelites JJ. You’re the flight surgeon: Raynaud’s phenomenon/hand arm vibration syndrome. Aerosp Med Hum Perform. 2020; 91(5):459–461.

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