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[IEEE 2018 IEEE International Symposium on Medical Measurements and Applications (MeMeA) - Rome (2018.6.11-2018.6.13)] 2018 IEEE International Symposium on Medical Measurements and Applications (MeMeA) - A Multi-label Architecture for Vision-based Measurement of Intervals of Pain
摘要： Vision-based measurement of pain can provide significant advantage in patient care and cost reduction. The subjective nature of pain, however, poses metrological challenges yet to be addressed. With this work, we designed and validated a measurement architecture for automatically estimating intervals of pain over time based on the analysis of facial expressions. A reference measurement procedure was set up for labelling subjective levels of pain as observed by a set of independent evaluators. By means of a multi-label strategy, the system was calibrated for managing the uncertainty of the information provided by the evaluators at the ground-truth level. Results obtained for different coverage probability values support the efficacy of the proposed platform and motivate further investigations.
关键词： vision-based measurement,pain monitoring,reference measurement procedure,ordinal quantity,Analysis of facial expression,multi-label classification
更新于2025-09-23 15:23:52
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The Effectiveness of Infrared Thermography in Patients with Whiplash Injury
摘要： Objective : This study aims to visualize the subjective symptoms before and after the treatment of whiplash injury using infrared (IR) thermography. Methods : IR thermography was performed for 42 patients who were diagnosed with whiplash injury. There were 19 male and 23 female patients. The mean age was 43.12 years. Thermal differences (?T) in the neck and shoulder and changes in the thermal differences (?dT) before and after treatment were analyzed. Pain after injury was evaluated using visual analogue scale (VAS) before and after treatment (?VAS). The correlations between ?dT and ?VAS results before and after the treatment were examined. We used Digital Infrared Thermal Imaging equipment of Dorex company for IR thermography. Results : The skin temperature of the neck and shoulder immediately after injury showed 1–2°C hyperthermia than normal. After two weeks, the skin temperature was normal range. ?T after immediately injuy was higher than normal value, but it was gradually near the normal value after two weeks. ?dT before and after treatment were statistically significant (p<0.05). VAS of the neck and shoulder significantly reduced after 2 week (p=0.001). Also, there was significant correlation between ?dT and reduced ?VAS (the neck; r=0.412, p<0.007) (the shoulder; r=0.648, p<0.000). Conclusion : The skin temperature of sites with whiplash injury is immediately hyperthermia and gradually decreased after two weeks, finally it got close to normal temperature. These were highly correlated with reduced VAS. IR thermography can be a reliable tool to visualize the symptoms of whiplash injury and the effectiveness of treatment in clinical settings.
关键词： Thermal difference,Visual analogue scale,Whiplash injury,Pain,Infrared thermography
更新于2025-09-23 15:22:29
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The background and philosophy behind daylight photodynamic therapy
摘要： Conventional photodynamic therapy (PDT) is associated with side effects, primarily related to the waiting time between pretreatment with application of photosensitizer and illumination. Pain during illumination is a major issue for the patients and options for effective pain relief are limited. Post-treatment inflammation can often be severe and cause inconvenient down-time for the patients and their employers. To avoid the problems of pain and patients crowding in the clinic we eliminated red light treatment of high PpIX concentration and introduced illumination in daylight which may be performed at home. We also investigated if protoporphyrin IX (PpIX) could be activated continuously during its formation which might reduce pain and inflammation. Continuous activation of PpIX during its formation turned out to minimize pain as single PpIX molecules are activated continuously without accumulation of PpIX in the skin. PpIX molecules are formed in the mitochondria and the photodynamic effect only takes place in the mitochondria when continuously activated. This results primarily in apoptosis with little inflammation. Continuous activation of PpIX can be obtained by performing photodynamic therapy in daylight, as well as with daylight-emitting light sources of appropriate wavelengths. Use of daylight prevents the patients from crowding in the clinic. Daylight-PDT completely fulfils the purpose of minimizing pain and inflammation, as well as limiting the strain on the clinic treating the patients.
关键词： Photochemotherapy,Pain,Inflammation,Protoporphyrin IX
更新于2025-09-23 15:22:29
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Three-dimensional intraoperative imaging with O-arm to establish a working trajectory in percutaneous endoscopic lumbar discectomy
摘要： Introduction: Successful percutaneous endoscopic lumbar discectomy (PELD) requires an appropriate working trajectory. Due to the complexity of spinal anatomy, this is difficult to verify with conventional 2-dimensional fluoroscopy. Aim: Here we assessed the feasibility and utility of the O-arm for establishing the working trajectory for PELD. Material and methods: We retrospectively reviewed the records of 89 patients with lumbar disc herniation who underwent PELD using the O-arm. The working trajectory was evaluated with standard fluoroscopic images or 3-dimensional, volumetric computed tomography scan. Based on the detail provided by the multiplanar view, we confirmed the ideal working trajectory and adjusted the surgical approach accordingly. Results: At the 12-month follow-up, based on MacNab’s criteria, 85.9% of patients showed an excellent or good outcome. There were no major complications. Conclusions: The O-arm provides detailed multiplanar intraoperative high-quality imaging for PELD, and enables the surgeon to ascertain the surgical anatomy, determine the optimal working trajectory, and improve the accuracy of surgery.
关键词： O-arm,disc herniation,intraoperative imaging,percutaneous endoscopic lumbar discectomy,low back pain
更新于2025-09-23 15:21:21
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Lack of relationship between epidermal denervation by capsaicin and incisional pain behaviours: A laser scanning confocal microscopy study in rats
摘要： BACKGROUND: Spontaneous pain after surgical incision is a significant problem for most post-operative patients. Pain management that relies on opioids is hindered by numerous side effects, fueling interest in non-opioid alternatives and multimodal approaches. Subcutaneous capsaicin infiltration has shown potential for reducing post-operative pain, but there are unanswered questions about safety and possible side effects. In adult rats, we characterized the analgesic effects of pre-operative capsaicin infiltration into the skin prior to plantar incision and assessed wound healing and epidermal innervation. METHODS: The surgical site on the plantar surface of the rat hind paw was infiltrated with 1% capsaicin or vehicle 30 minutes or 1 week prior to surgical incision. Spontaneous and evoked pain behaviors were assessed. Digital images of incised hind paws were used to quantify the surface area of the wound after suture removal. Epidermal nerve fiber quantification was performed on peri-incisional tissue biopsies. RESULTS: Intraplantar administration of capsaicin 30 minutes before surgical incision attenuated spontaneous pain behaviors, heat hyperalgesia, epidermal innervation, but it did not alter the rate of wound healing. Incisional pain hypersensitivity returned to baseline 2 weeks post-incision, at a time when no recovery of epidermal innervation is observed. CONCLUSIONS: Subcutaneous infiltration of capsaicin prior to surgical incision attenuated incision-induced pain behaviors and reduced epidermal innervation around the incision site. The long-lasting epidermal denervation by capsaicin had no impact in the rate of wound healing and recovery from pain behaviors.
关键词： epidermal innervation,capsaicin,rats,wound healing,post-operative pain
更新于2025-09-23 15:21:01
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USING PHOTOPLETHYSMOGRAPHY IMAGING FOR OBJECTIVE CONTACTLESS PAIN ASSESSMENT
摘要： This work presents an extension to the known Analgesia Nociception Index (ANI), which provides an objective estimation of the current depth of analgesia. An adequate “measure” would facilitate so-called balanced anesthesia. Generally, ANI is computed using heart rate variability or rather beat-to-beat intervals based on an electrocardiogram (ECG). There are clinical situations where no ECG monitoring is available or required, but only photoplethysmography (PPG), e.g., in some cases in postoperative care or pain therapy. In addition, a combination of PPG and ECG for obtaining beat-to-beat intervals may lead to increased robustness and reliability for dealing with artifacts. This work therefore investigates the computation of ANI using standard PPG. In addition, new methods and opportunities are presented using contactless PPG imaging (PPGI). PPGI?enables contactless PPG recordings for deriving beat-to-beat intervals as well as analysis of local perfusion and wounds.
关键词： PPG,nociception,image based PPG,anesthesiology,ECG,pain,analgesia,heart rate variability,PPGI
更新于2025-09-23 15:21:01
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There does not seem to be any benefit from using low-level laser therapy to treat temporomandibular pain after 1??year
摘要： There does not seem to be any benefit from using low-level laser therapy to treat temporomandibular pain after 1 year.
关键词： low-level laser therapy,orofacial pain,randomized clinical trial,pain,General dentistry
更新于2025-09-23 15:19:57
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Clinical efficacy comparison of low-temperature plasma radiofrequency ablation and Nd:YAG laser in treating recurrent acquired nasolacrimal duct obstruction
摘要： To evaluate the effectiveness and safety of low-temperature plasma radiofrequency ablation (coblation) and Nd:YAG laser in treating recurrent nasolacrimal duct obstruction. A prospective study was performed on patients who agreed to be treated with coblation or Nd:YAG laser for recurrent nasolacrimal duct obstruction after failed lacrimal Nd:YAG laser combined with silicone intubation. The visual analogue scale (VAS) pain grade was assessed at baseline, immediately, and 3 and 7 days after surgery. The degree of watering, lacrimal passage irrigation, and complications were also evaluated 1 week and 1, 3, and 6 months after surgery. Ninety-five patients who met the criteria for recurrent nasolacrimal duct obstruction from February 2018 to February 2019 were included in this study, with 46 patients receiving coblation and 49 patients Nd:YAG laser. The intraoperative and postoperative (3 days after surgery) VAS pain grades of the patients who received coblation were significantly lower than those who received Nd:YAG laser (P < 0.001). The number of patients in the coblation group who achieved complete clinical relief (no epiphora symptoms with fluent lacrimal passage irrigation) was significantly larger than that in the lacrimal Nd:YAG laser group at 1, 3, and 6 months after surgery (P = 0.033, P = 0.006, P = 0.003, respectively). During the follow-up period, there were no unexpected complications in either group. Compared with Nd:YAG laser, coblation performed well in alleviating pain and maintaining sustained disease relief and may therefore be an alternative to conventional laser or dacryocystorhinostomy surgery in the management of recurrent nasolacrimal duct obstruction.
关键词： Nd:YAG laser,Recurrent acquired nasolacrimal duct obstruction,Low-temperature plasma radiofrequency ablation,VAS pain grade
更新于2025-09-23 15:19:57
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Effects of mTOR inhibitors on neuropathic pain revealed by optical imaging of the insular cortex in rats
摘要： In the pain matrix, the insular cortex (IC) is mainly involved in discriminative sensory and motivative emotion. Abnormal signal transmission from injury site causes neuropathic pain, which generates enhanced synaptic plasticity. The mammalian target of rapamycin (mTOR) complex is the key regulator of protein synthesis; it is involved in the modulation of synaptic plasticity. To date, there has been no report on the changes in optical signals in the IC under neuropathic condition after treatment with mTOR inhibitors, such as Torin1 and XL388. Therefore, we aimed to determine the pain-relieving effect of mTOR inhibitors (Torin1 and XL388) and observe the changes in optical signals in the IC after treatment. Mechanical threshold was measured in adult male Sprague-Dawley rats after neuropathic surgery, and therapeutic effect of inhibitors was assessed on post-operative day 7 following the microinjection of Torin1 or XL388 into the IC. Optical signals were acquired to observe the neuronal activity of the IC in response to peripheral stimulation before and after treatment with mTOR inhibitors. Consequently, the inhibitors showed the most effective alleviation 4 h after microinjection into the IC. In optical imaging, peak amplitudes of optical signals and areas of activated regions were reduced after treatment with Torin1 and XL388. However, there were no significant optical signal changes in the IC before and after vehicle application. These findings suggested that Torin1 and XL388 are associated with the alleviation of neuronal activity that is excessively manifested in the IC, and is assumed to diminish synaptic plasticity.
关键词： Neuropathic pain,insular cortex (IC),Optical imaging,Cortical activity,mTOR complex
更新于2025-09-23 15:19:57
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Low-level laser-aided orthodontic treatment of periodontally compromised patients: a randomised controlled trial
摘要： Low-level laser irradiation (LLLI) shows effects in orthodontic pain relief and periodontal inflammation control. The aim of this article is to investigate the analgesic and inflammation-modulatory effects of low-level laser irradiation among orthodontic patients with compromised periodontium. A randomised controlled trial with split-mouth design was conducted in 27 adults with treated and controlled chronic periodontitis over 6 months. One side of the dental arch underwent repeated treatment under a 940-nm diode laser (EZlase; Biolase Technology Inc.) with a beam size of 2.8 cm2 for 60 seconds at 8.6 J/cm2, whilst the other side received pseudo-laser treatment. Laser irradiation was applied repeatedly for 8 times during the first 6 weeks after bracket bonding and monthly thereafter until the end of orthodontic treatment. Subjective pain (assessed by visual analogue scale in pain diary and by chairside archwire activation), periodontal status (assessed by periodontal clinical parameters), cytokines in gingival crevicular fluid (interleukin 1β, prostaglandin E2, substance P) and periodontopathic bacteria (Porphyromonas gingivalis and Treponema denticola) in supragingival plaque were assessed. The intensity of pain was lower on the laser-irradiated side at multiple follow-up visits (P < 0.05). The pain subsided 1 day earlier on the laser side, with a lower peak value during the first week after initial archwire placement (P < 0.05). The laser side exhibited a smaller reduction in bite force during the first month (mean difference = 3.17, 95% CI: 2.36–3.98, P < 0.05 at 1-week interval; mean difference = 3.09, 95% CI: 1.87–4.32, P < 0.05 at 1-month interval). A smaller increase was observed in the plaque index scores on the laser side at 1-month (mean difference = 0.19, 95% CI: 0.13–0.24, P < 0.05) and in the gingival index scores at the 3-month follow-up visit (mean difference = 0.18, 95% CI: 0.14–0.21, P < 0.05). Laser irradiation inhibited the elevation of interleukin-1β, prostaglandin E2 and substance P levels during the first month (P < 0.05). However, no intergroup difference was detected in the bacteria levels. Low-level laser irradiation exhibits benefits in pain relief and inflammation control during the early stage of adjunctive orthodontic treatment in periodontally compromised individuals.
关键词： Orthodontic-periodontal joint treatment,Randomised clinical trial,Low-level laser irradiation,Orthodontic pain,Periodontal inflammation
更新于2025-09-23 15:19:57