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[Colors in the intensive therapy environment: perceptions of patients and professionals].

The use of colors in the environment of an Intensive Care Unit (ICU) may interfere in the welfare of both professionals and patients. This study is aimed at analyzing the perceptions of professionals and patients regarding the colors used in the intensive care environment, identifying those considered pleasant and unpleasant. This is a descriptive-exploratory research with a quantitative-qualitative focus. The sample was comprised of hospitalized patients and professionals at three public hospitals ICUs in the city of Goiânia, State of Goiás. The colors considered most pleasant for ICUs were light blue and light green. Light yellow, beige, gray, pink and guava were also pointed out as pleasing. Red and black were appointed as the most unpleasant. Professionals and patients demonstrated preference for varied colors, something that can be used as a way of improving the atmosphere of ICUs.

Color↗

Real-time evaluation of the effectiveness of microwave coagulation therapy for hepatocellular carcinoma using color Doppler imaging.

Percutaneous microwave coagulation therapy (PMCT) is a new technique for the treatment of hepatocellular carcinoma (HCC). However, it is difficult to distinguish those lesions in which necrosis has been induced from the viable residual lesions during the procedure, because the margin of the tumor becomes unclear during PMCT. We determined the area of necrotic lesions during the procedure using color Doppler imaging. PMCT was performed on 10 patients (17 lesions) with recurrent HCC. The electrode of the microwave delivery system was moved around the tumor and the surrounding area until color mosaic images disappeared from the entire area of the tumor. The areas in which necrotic tissue was indicated by color Doppler imaging were later confirmed by other modalities such as angiography or contrast-enhanced computed tomography. This leads us to believe that real-time, effective evaluation of PMCT is possible with color Doppler imaging.

Aged↗

[Color Doppler controlled compression therapy of puncture aneurysms--a noninvasive therapy concept].

After transfemoral catheterization, pseudoaneurysms can occur in about 0.1-0.05% of cases, especially after the use of large instruments and a faulty puncture technique. Today, pseudoaneurysms can be easily and accurately diagnosed with the help of duplex and color Doppler ultrasound. Apart from its diagnostic application, color Doppler ultrasound also offers a noninvasive and cheap alternative therapy mode as compared to surgical repair. The purpose of our study was to evaluate the therapeutic efficiency of an ultrasound-guided compression technique for postpunctional pseudoaneurysms. Over a 12-month period, nine patients were sonographically diagnosed with postpunctional pseudoaneurysm of the femoral superficial artery. The compression therapy was only applied if no contraindications (e.g. rupture, retroperitoneal site of the lesion, infection, large haematoma with suspected ischaemia, and necrosis) were present. Two of the nine patients were primarily excluded from therapy because of a high risk of rupture or a large haematoma. Five patients of the remaining seven have been successfully treated. In one of the unsuccessfully treated patients, only a partial thrombosis of the aneurysm was obtained, followed by complete spontaneous thrombosis 4 days later. The second compression failed because of the 4-month time interval between angiography and compression therapy. A successful therapy clearly depended on the time interval between puncture and compression. We could not find any significant correlation between the aneurysm volume and the duration of compression. Color Doppler ultrasound-guided therapy is a noninvasive easily applicable, and cheap alternative to surgical repair of postpunctional pseudoaneurysms.

Adult↗

Analysis of angiogenic profiles by estimation of tumor blood flow with colored dye extraction microspheres after antiangiogenic therapy.

No study has directly estimated tumor blood flow after antiangiogenic therapy. Using dye extraction colored microspheres, we estimated blood flow in a rat LY80 tumor model before and after antiangiogenic therapy with TNP-470. Dyed microspheres were infused into the tumor-bearing rats. The dye was extracted and its concentration was quantified by spectrophotometry. Tumor blood flow corrected for wet weight (ml. min(-1)g(-1)) was calculated as follows (AU = absorbency units): (blood flow to tumor) = (AU per gram of tumor) x (reference withdrawal rate)/(AU per gram of reference blood). Tumor tissues with or without TNP-470 were also examined histologically. Tumor blood flow 1 week after transplantation could be predicted by the simple regression equation. In the groups treated with TNP-470, this simple regression equation shifted to the left, despite virtually no difference in the results of pathological examination. In LY80 tumors 2 weeks after transplantation, blood flow in tumors treated with TNP-470 was higher than without TNP-470. This technique can be used to obtain information about the angiogenic status within tumor before and after antiangiogenic therapy. These angiogenic profiles may provide important clues to optimal antiangiogenic therapy, combinations of antiangiogenic treatment and cytotoxic therapy, and schedules for combination therapy.

Angiogenesis Inhibitors↗

Normal uterine arterial blood flow in postmenopausal women assessed by transvaginal color Doppler sonography: the effect of hormone replacement therapy.

We used transvaginal color Doppler sonography to study the effect of hormone replacement on the uterine arterial blood flow for 203 postmenopausal women. The regimens studied involved estrogen replacement alone, continuous combined estrogen and progestogen, and estrogen followed sequentially by combined estrogen-progestogen. The mean pulsatility index fell to 65% +/- 9% and the mean resistive index fell to 87% +/- 4% of baseline during the first month of therapy (P < 0.0001). The addition of a progestogen did not alter the effect of estrogen alone (P > 0.5). Our findings suggest that the increase in vascular flow occurs even in women who begin therapy long after menopause.

Arteries↗

Long-term prognosis of parathyroid function after successful percutaneous ethanol injection therapy (PEIT) guided by color Doppler flow mapping in chronic dialysis patients.

Secondary hyperparathyroidism (2 HPT) is a representative disease of dialysis osteopathy, with the lesion that makes fibrous osteitis and the parathyroid hyperplasia by the hyper secretion of parathyroid hormone (PTH). This research examines the usefulness of selective percutaneous ethanol injection therapy (PEIT) of parathyroid glands in order to treat and control for 2 HPT. PEIT was performed in 46 patients resistant to calcitriol pulse therapy and all glands larger than 5 mm in diameter were destroyed by ethanol guided by power Doppler flow mapping. Serum intact-PTH (iPTH) levels fell from 633.3 +/- 359.9 to 226.3 +/- 204.7 pg/mL at three weeks and were maintained at 289.9 +/- 222.4 pg/mL at one year after PEIT. Total alkaline phosphatase activity fell from 384.9 +/- 160.1 to 234.0 +/- 110.5 IU/L at one year after PEIT. In 19 patients, i-PTH levels fell into relative hypoparathyroidism (iPTH < 160 pg/mL) at three weeks after PEIT: however, they recovered at one year after PEIT (191.1 +/- 29.6 pg/mL). In total, parathyroid function was maintained at optimal range (160 < iPTH < 360 pg/mL) in 80.4% of patients at one year after PEIT with appropriate medical therapy. As for the complications, recurrent nerve palsy was observed in only one patient, but was reversible. In conclusion, selective PEIT appears to be able to control appropriate parathyroid function and to be the method of choice to treat 2 HPT prior to parathyroidectomy.

Adult↗

[Possibilities and limitations of color duplex guided compression therapy of puncture-induced blood vessel lesions in the groin].

AIM: Colour Doppler imaging (CDI) is a useful tool for non-invasive diagnosis and treatment of postcatheterisation lesions of the femoral artery. The aim of the present study was to evaluate success and limitations of the method in unselected patients. MATERIAL AND METHODS: A total of 29 patients, including 24 patients with pseudoaneurysms and 5 patients with arteriovenous fistulas, were treated by CDI-guided compression therapy. RESULTS: 17 of 24 (71%) pseudoaneurysms, but only 1 of 5 (20%) arteriovenous fistulas were successfully occluded. Successful treatment of pseudoaneurysms was limited by continuous anticoagulation and local pain during compression. However, arteriovenous fistulas, except one, could not be occluded due to high flow velocities in the shunt. CONCLUSION: CDI-guided compression therapy is the treatment of choice for postcatheterisation pseudoaneurysms, while arteriovenous fistulas should be repaired surgically. If possible, anticoagulation therapy should be discontinued and analgesic drugs should be prescribed.

Adult↗

Neurocognitive deficits of alcoholism: an intervention.

This study investigated the impact of cognitive retraining on a sample of neurocognitively impaired alcoholics (N = 45). The treatment group received training on a hierarchical cumulative learning program. In this paradigm, the subjects mastered an isolated concept to automaticity, at which point a second and then a third concept were added. The training group demonstrated significantly improved performance over the practice and control groups on the three measures taken from the Wisconsin Card Sorting Test: total number of categories, perseverative errors, and nonperseverative errors. Neither the practice nor the control group exhibited significantly improved performance. These data lend support to an information processing perspective and are at odds with research that infers that neurophysiological substrates preclude normal functioning in alcoholics and argues that mere exposure of alcoholics to training stimuli prompts significant improvements. Treatment implications are discussed.

Adolescent↗

Multiple color changes following laser therapy of cosmetic tattoos.

OBJECTIVE: To emphasize the wisdom of small test areas when treating cosmetic tattoos and the need for multiple laser systems. METHODS: A 48-year-old woman requested removal of permanent makeup (cosmetic tattoos) of her eyebrows and around her lips. Physical examination revealed a brown tattoo of both eyebrows and dark red lip liner around both lips. A test area was performed on the red tattoo of the lips. A frequency-doubled Nd:YAG laser (532 nm, 2.0 J/cm2, 2 mm spot size) was used for the lip area, while the same laser at 1064 nm, 3.9 J cm2, 2 mm spot size was utilized for the eyebrows. The lip area immediately turned black. The patient returned for follow-up 1 month later; the black ink on the lip was treated with the same laser at 1064 nm, 3 mm spot size, 4.2 J/cm2, with satisfactory resolution in two monthly treatments. Both brown eyebrow turned bright orange and were treated with 532 nm, 3 mm, 3.0 J/cm2. One month later the eyebrows were a mixture of yellow ink and dark green. The yellow area was treated with 532 nm, 3 mm, 2.3 J/cm2, while the dark green was treated with the 1064 nm, 3 mm spot size, 4.2 J/cm2. One month later little improvement was noted, so Q-switched ruby laser at 694 nm, 6 mm spot size, 16 J/cm2 was utilized. An additional four monthly treatments were given utilizing a combination of both ruby and 532 nm ND:YAG lasers for green and yellow pigment, respectively. RESULTS: Significant but incomplete resolution of the tattoo ink was achieved. CONCLUSION: Multiple laser systems are needed to remove cosmetic tattoos. Test areas must be done before treatment.

Eyebrows↗

[Intrapartum therapy-resistant fetal bradycardia--color Doppler sonographic diagnosis of umbilical cord compression due to fetal grasping].

Fetal heart rate pathology is seen in up to 40% of complications of the umbilical cord. We report a case in which long lasting bradycardia was associated with fetal grasping of the umbilical cord. Using colour doppler, the reason for the bradycardia could be detected. After vibro-acoustic stimulation the fetus released the grasp of the umbilical cord, following by a normalisation of the fetal heart rate and a spontaneous delivery two hours later. This case report underlines the importance of colour doppler for the diagnosis of fetal heart rate pathology.

Adult↗

Changes of skin blood flow and color on lesional and control sites during PUVA therapy for psoriasis.

BACKGROUND: Although the colors of psoriatic lesions, largely determined by erythema and scales, are important clinical indicators, expressing them in an objective manner is difficult. Cutaneous blood flow (CBF) also affects erythema. Serial measurement of these parameters during phototherapy was almost nonexistent. OBJECTIVE: The objectives of our study were to observe the changes of color parameters and the CBF of psoriatic lesions during PUVA therapy and to determine their clinical significance. METHODS: CBF, measured by laser Doppler flowmetry, and color parameters, measured by tristimulus colorimetry and reflectance spectrophotometry, were assessed in 13 patients with psoriasis who received PUVA therapy. RESULTS: The values of CBF, erythema index (EI), and a(*) (color parameter representing red-green axis) in psoriatic lesions were significantly different from those observed in the control sites before therapy. The parameters of psoriatic lesions normalized according to the clinical improvement and approached those of the control sites as PUVA therapy progressed. The values of melanin index (MI), L(*) (color parameter representing white-black axis), and b(*) (color parameter representing yellow-blue axis) showed no significant difference between the psoriatic plaques and the control sites. They all displayed changes toward darkening and indicated tanning induced by PUVA therapy. Serial changes presented a generally unidirectional pattern in the control sites. However, this was not always the case in psoriatic lesions because scale, infiltration, and erythema also affected the measurement of blood flow and the color of the skin. CONCLUSION: Color parameters and CBF were closely related with clinical improvement according to consecutive phototherapy. They may serve as objective indices for the visible morphology and underlying lesional pathophysiology of psoriasis.

Adult↗