scholarly journals Comparison the Efficacy of EMLA Cream versus EMLA with High Frequency Sonophoresis in Decreasing Onset Time to Topical Anaesthesia in Adult Volunteers: A Pilot Study

2020 ◽  
Author(s):  
Vijay Adabala ◽  
Ajit Kumar ◽  
Praveen Talawar ◽  
Mridul Dhar ◽  
Gandham Ravi
Keyword(s):  
High Frequency ◽  
Adult Population ◽  
Onset Time ◽  
Pain Clinic ◽  
Topical Anaesthesia ◽  
High Frequency Ultrasound ◽  
Emla Cream ◽  
Pain Scores ◽  
Significant Difference ◽  
Frequency Ultrasound

Background: Sonophoresis or phonophoresis is a well-known transdermal drug delivery mechanism. Usage of high frequency ultrasound for sonophoresis was initiated in late 1950s while the usage of low-frequency sonophoresis was investigated significantly during the past two decades. The objective was to analyze the efficacy of high frequency ultrasound probe in the penetration of EMLA cream in decreasing onset time for topical anaesthesia in adult healthy volunteers. Methods: A prospective, open labelled, comparative study was conducted on patients reporting at the Pain Clinic our institute. Subjects received the intervention USG probe with EMLA either on the left or the right hand based on a random number chart, with the other hand of the same subject acting as a control. In group USG, the probe was applied directly on the cream without any added pressure. Sensory testing was done every 10 minutes by pin prick on both the hands of the patients NRS scores of both the hands were recorded at 10.20,30 and 40 minutes. Results: Total 20 patients were selected for the study. Although a significant decrease in the pain scores in both the groups was observed after 40minutes, (p<0.05) both the groups are comparable at each point of time. We could not find any significant decrease in pain scores when groups are compared in intervals during the study period. Conclusion: There is no significant difference in decreasing the intensity of pain scores upon application of ultrasound over EMLA in an adult population. Further studies have to be done to prove the efficacy in a larger population and pediatric ones.

scholarly journals Photoacoustic and High-Frequency Ultrasound Imaging of Systemic Sclerosis Patients

2020 ◽  
Author(s):  
Brigit E. Kersten ◽  
Khalid Daoudi ◽  
Cornelia H van den Ende ◽  
Frank H van den Hoogen ◽  
Chris L. de Korte ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Oxygen Saturation ◽  
High Frequency ◽  
Skin Thickness ◽  
Healthy Individuals ◽  
High Frequency Ultrasound ◽  
The Third ◽  
Significant Difference ◽  
Primary Raynaud’S Phenomenon ◽  
Frequency Ultrasound

Abstract Introduction: Systemic sclerosis starts with an early phase characterized by Raynauds phenomenon, puffy fingers/hands, autoantibodies and a scleroderma nailfold­microscopic pattern. Alterations in the nailfoldmicroscopic pattern are not evident in all early SSc patients. Photoacoustics(PA) and high-frequency ultrasound (HFUS) could fulfill this need. The former can measure oxygen saturation while the latter can measure skin thickening. We hypothesize that photoacoustics and high-frequency ultrasound can distinguish (early) SSc patients from individuals with primary Raynaud's phenomenon (PRP) by measuring oxygenation of the fingertip and skin thickening.Methods: We compared measurements of the third finger in (early)SSc patients to healthy and PRP individuals. The level of oxygenation and skin thickness were compared between groups. Nailfoldcapillaroscopy was performed on all subjects.Results: Thirty-one adult subjects participated in this study: twelve patients with SSc, 5 patients with early SSc, 5 volunteers with PR and 9 healthy controls. We found a significant difference in oxygen saturation between (early) SSc patients (80.8% ± 8.1 and 77,9% ± 10.5 ) and individuals with PRP (93.9% ± 1.1). Measurements of skin thickening showed a significant difference in (early) SSc patients compared to individuals with PRP (0.48 ± 0.06 mm and 0.51 ±0.16 mm vs. 0.27 ± 0.01 mm). There was no significant difference between healthy and PRP individuals in oxygenation or skin thickening.Conclusion: Photoacoustic and high-frequency ultrasound can distinguish between (early)SSc, PRP and healthy individuals in both oxygenation and skin thickening.

scholarly journals AB0582 DIAGNOSING SYSTEMIC SCLEROSIS WITH PHOTOACOUSTIC AND HIGH-FREQUENCY ULTRASOUND IMAGING

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1588.1-1588
Author(s):  
B. Kersten ◽  
K. Daoudi ◽  
C. H. M. Van den Ende ◽  
F. Van den Hoogen ◽  
C. De Korte ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Early Diagnosis ◽  
Oxygen Saturation ◽  
High Frequency ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Skin Thickness ◽  
High Frequency Ultrasound ◽  
Significant Difference ◽  
Frequency Ultrasound

Background:Vasculopathy is already evident in early systemic sclerosis (SSc); Raynaud’s phenomenon and typical nailfoldcapillaroscopic findings are part of the criteria of very early diagnosis of SSc (VEDOSs) (1). As not all early SSc patients have alterations in their nailfoldcapillaries, there is need for other diagnostic tools. Photoacoustics(PA) and high-frequency ultrasound (HFUS) might be able to fulfill this need (2). The former can measure the oxygen saturation of hemoglobin by using short pulsed laser light while the latter can provide high-resolution images that allow measuring skin thickening distal from DIP joint, which could be used to determine skin involvement early.Objectives:We hypothesize that photoacoustics and high-frequency ultrasound can distinguish (early) SSc patients from individuals with primary Raynaud’s phenomenon (PR) by measuring the oxygenation (by PA) of the fingertip and skin thickening (by HFUS).Methods:In our cross-sectional study, we compared measurements of the third finger in (early)SSc patients with individuals with PR and healthy volunteers. Smoking and beta-blockage were exclusion criteria. The level of oxygenation (by PA) and skin thickness (by HFUS) were compared between groups. Nailfoldcapillaroscopy was performed on all subjects and analyzed for the pattern.Results:Thirty-one adult subjects participated in this study: twelve patients with SSc, 5 patients with early SSc, 5 volunteers with PR and 9 healthy controls.We found a significant difference in median (IQR) oxygen saturation between earlySSc patients 75.9% (IQR 75.1%-86.6%) and subjects with PR 94.1% (IQR 93.1%-94.5%) (p=0.0002) using the Wilcoxon rank-sum test (figure 1).Figure 1.Boxplot of saturation (%) per group.Measurements of skin thickening also showed a significant difference in early SSc patients compared to subjects with PR, respectively 0.5mm (IQR 0.4mm-0.5mm) vs. 0.3mm (IQR 0.3mm-0.3mm), P=0.0002 (figure 2).Figure 2.Boxplot of skin thickness (mm) per group.Conclusion:Our results demonstrate that photoacoustic and high-frequency ultrasound can distinguish between (early)SSc and PR in both oxygenation saturation and skin thickening. In a larger prognostic study we want to determine the value of photoacoustic and high frequency ultrasound in diagnosing earlySSc.References:[1]Minier T, Guiducci S, Bellando-Randone S, Bruni C, Lepri G, Czirjak L, et al. Preliminary analysis of the very early diagnosis of systemic sclerosis (VEDOSS) EUSTAR multicentre study: evidence for puffy fingers as a pivotal sign for suspicion of systemic sclerosis. Annals of the rheumatic diseases. 2014;73(12):2087-93.[2]Wang LV, Yao J. A practical guide to photoacoustic tomography in the life sciences. Nature methods. 2016;13(8):627-38Disclosure of Interests:Brigit Kersten: None declared, Khalid Daoudi: None declared, C.H.M. van den Ende: None declared, FHJ van den Hoogen Consultant of: AbbVie, Actelion, Biogen, BMS, Celltrion, Corbus, Eli-Lilly, Mundipharma, Pfizer, Sanofi-Genzyme, Speakers bureau: Amgen, Boehringer-Ingelheim, Novartis, CL de Korte: None declared, Madelon Vonk Grant/research support from: Janssen and Ferrer, Consultant of: Boehringer Ingelheim, Janssen and GSK, Speakers bureau: Boehringer Ingelheim, BMS and Roche

scholarly journals SAT0305 PERFORMANCE OF HIGH FREQUENCY ULTRASOUND IN THE ASSESSMENT OF SKIN INVOLVEMENT IN SYSTEMIC SCLEROSIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1097.3-1098
Author(s):  
G. Lettieri ◽  
V. Picerno ◽  
D. Temiz Karadağ ◽  
M. C. Padula ◽  
G. A. Mennillo ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
High Frequency ◽  
Disease Duration ◽  
Skin Thickness ◽  
Skin Involvement ◽  
High Frequency Ultrasound ◽  
Upper Arm ◽  
Significant Difference ◽  
Disease Stages ◽  
Frequency Ultrasound

Background:The modified Rodnan skin score (mRSS) is the current gold standard for skin assessment in systemic sclerosis (SSc) both in clinical trials and practice. High frequency ultrasound (HFUS) has been suggested to offer a quantitative assessment of skin thickness in SSc by several studies, however results are inhomogeneous with regards to the machine used, number of imaged sites, as well as the various stages of skin involvement.Objectives:Aim of this cross-sectional study was to compare performance of HFUS in the assessment of skin involvement in diffuse cutaneous SSc (dcSSc) patients, at different disease stages, as compared with healthy controls (HC).Methods:Dorsal finger, hand, forearm and upper arm skin of consecutive dcSSc patients, at different disease stages, and of matched-HC were scanned bilaterally using HFUS. Two investigators, expert in MSK ultrasound, blinded to the clinical details, measured skin thickness using Esaote MyLab70 equipped with a 22 MHZ probe. Clinical involvement was assessed by a blinded operator using the mRSS and results were compared with imaging data. Statistical analysis was performed using GraphPad Prism software V.7.0.Results:A total of 704 HFUS images were obtained from 22 dcSSc patients [20 Female, mean age 49 (±11) years, 12 with ≤ 5 years disease duration] and 22 HC [20 Female, mean age 50.7 (±6.7) years]. Skin thickness was significantly higher in SSc patients than in HC at fingers (p<0.0001) and hands (p<0.0001), while no significant difference was found at the forearms and upper arms (p>0.05). HFUS showed a good discriminative ability between SSc and HC skin at fingers and hands (AUC 0.91, 0.81, 0.6 and 0.65 for fingers, hands, forearms and upper arms respectively). When analysing the subgroup of SSc patients with ≤5 years disease duration, HFUS showed a slightly lower performance in discriminating between SSc without clinical skin involvement (site mRSS=0) and HC (AUC 0.68, 0.57, 0.68 for hands, forearms and upper arms respectively). Mean HFUS skin thickness significantly correlated with mRSS at site of analysis (hand: r=0.78, p=<0.0001; forearm: r=0.47, p=0.0013; upper arm: r=0.52, p=0.0003) and total mRSS (hand: r=0.53, p=0.0002; forearm: r=0.63, p<0.0001; upper arm: r=0.63, p<0.0001). No significant correlation was found between finger skin thickness and mRSS (both local and total, p>0.05). Interobserver reliability for skin thickness was good to excellent at all sites with intraclass correlation coefficient ranging between 0.79 and 0.94.Conclusion:HFUS of the skin is a reliable measure of skin involvement in SSc. Studies with higher number of patients with different clinical features are needed to explore the potential of HFUS to discriminate between healthy and SSc skin, including sites at a preclinical stage of involvement.Disclosure of Interests:None declared

scholarly journals Photoacoustic and high-frequency ultrasound imaging of systemic sclerosis patients

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Khalid Daoudi ◽  
Brigit E. Kersten ◽  
Cornelia H. M. van den Ende ◽  
Frank H. J. van den Hoogen ◽  
Madelon C. Vonk ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Oxygen Saturation ◽  
High Frequency ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Skin Thickness ◽  
Healthy Controls ◽  
High Frequency Ultrasound ◽  
Significant Difference ◽  
Frequency Ultrasound

Abstract Introduction Systemic sclerosis starts with an early phase characterized by Raynaud’s phenomenon, puffy fingers/hands, autoantibodies, and a scleroderma nailfold microscopic pattern. Alterations in the nailfold microscopic pattern are not evident in all early SSc patients. Photoacoustics (PA) and high-frequency ultrasound (HFUS) could fulfill this need. The former can measure oxygen saturation while the latter can measure skin thickening. We hypothesize that photoacoustics and high-frequency ultrasound can distinguish (early) SSc patients from individuals with primary Raynaud’s phenomenon (PRP) by measuring oxygenation of the fingertip and skin thickening. Methods We compared measurements of oxygenation and skin thickness of the third finger between (early) SSc patients and PRP individuals and healthy controls. The spearman rank correlation was used to analyze an association between capillary density and oxygen saturation of the fingers. Results Thirty-one adult subjects participated in this study: twelve patients with SSc, 5 patients with early SSc, 5 volunteers with PR, and 9 healthy controls. We found a significant difference in oxygen saturation between (early) SSc patients (80.8% ± 8.1 and 77.9% ± 10.5) and individuals with PRP (93.9% ± 1.1). Measurements of skin thickening showed a significant difference in (early) SSc patients compared to individuals with PRP (0.48 ± 0.06 mm and 0.51 ± 0.16 mm vs. 0.27 ± 0.01 mm). There was no significant difference between healthy and PRP individuals in oxygenation or skin thickening. Conclusion Photoacoustic and high-frequency ultrasound could help to distinguish between (early) SSc, PRP, and healthy individuals in both oxygenation and skin thickening.

scholarly journals EFFECTS OF LOW FREQUENCY ULTRASOUND COMPARE WITH HIGH FREQUENCY ULTRASOUND IN KNEE OSTEOARTHRITIS

2012 ◽  
Vol 1 (1) ◽  
pp. 9-12
Author(s):  
Syeda Amool Sakeena Rizvi ◽  
Syed Abid Mehdi Kazmi ◽  
Sumaira Imran Farooqi ◽  
Jharna Devi
Keyword(s):  
High Frequency ◽  
Low Frequency ◽  
High Frequency Ultrasound ◽  
Multiple Treatment ◽  
Knee Oa ◽  
Significant Difference ◽  
Low Frequency Ultrasound ◽  
Group A ◽  
Group B ◽  
Frequency Ultrasound

OBJECTIVE To compare the effectiveness of low and high frequency ultrasound (US) technique for treatment of osteoarthritis (OA) of knee joint. It is a pre-post design was used with multiple treatment therapies (A and B). The study was conducted on the 310 patients. The patients were diagnosed knee OA by the orthopedic doctor and recommended to the Physiotherapy department of North and Clifton Campus of Ziauddin Hospital. In this study 310 patients were divided into two groups. Group A of 155 patients received low frequency US treatment of 0.01MHz frequency for 10 min and at the same time Group B of 155 patients received high frequency US treatment of 1MHz for about 3 min. Both the groups had 6 sessions in 3 weeks. There was a mean reduction in the pain and disability with difference of low frequency US and high frequency US pre score and post score treatments of both the groups is 1.2± 0.3 and 4.1± 1.0, there was statistically significant difference between the effects of low frequency US and high frequency US in pain management of knee O.A (P < 0.05). There was difference between the effectiveness of low frequency US

scholarly journals Effectiveness of high frequency ultrasound on pressure ulcer

Medicine ◽  
2019 ◽  
Vol 98 (37) ◽  
pp. e17111 ◽  
Author(s):  
Xiang-qin Gao ◽  
Xiao-mei Xue ◽  
Jian-kang Zhang ◽  
Fei Yan ◽  
Qiu-xia Mu
Keyword(s):  
Pressure Ulcer ◽  
High Frequency ◽  
High Frequency Ultrasound ◽  
Frequency Ultrasound
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