Groner W, Winkelmann JW, Harris AG, Ince C, Messmer K, Nadeau RGOrthogonal polarization spectral imaging: A new method for study of the microcirculation. Nat Med 5: 1209-1212

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Nature Medicine (Impact Factor: 27.36). 11/1999; 5(10):1209-12. DOI: 10.1038/13529
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Available from: Gerrit J Bouma, Oct 05, 2015
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    • "" Direct techniques to observe the microcirculation. " In vivo microscopy of the microcirculation has been adapted to the clinical setting since the introduction of different generations of handheld cameras [53] [54]. The technique is based upon the visualization of red blood cells due to the absorption of green light by hemoglobin. "
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    ABSTRACT: Up until now the discussion in the literature as to the choice of fluids is almost completely restricted to the composition, with little to no attention paid to the importance of hemodynamic end points to achieve a desired optimal volume. The determination of fluid volume is left to the discretion of the attending physician with only surrogate markers as guidance the initiation and cessation of fluid therapy. In this review we aim to discuss the available literature on existing clinical and experimental criteria for the initiation and cessation of fluid therapy. Furthermore, we present recent data that have become available after the introduction of direct in-vivo microscopy of the microcirculation at the bedside, and discuss its potential influence on the existing paradigms and controversies in fluid therapy.
    Baillière&#x27 s Best Practice and Research in Clinical Anaesthesiology 09/2014; 28(3). DOI:10.1016/j.bpa.2014.06.002
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    • "Another example of an alternative advance is the use of orthogonal polarization spectral (OPS) imaging to assess the microcirculatory changes in mucosal surfaces during malaria infection [32]. The clear images of sublingual and rectal mucosa generated by the OPS device allowed for the first time the visualization in vivo of microvessel obstruction by IE in adult patients with severe malaria, confirming the evidence derived from pathological studies of fatal cases [33]. "
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    ABSTRACT: Understanding the mechanisms underlying the pathophysiology of cerebral malaria in patients with Plasmodium falciparum infection is necessary to implement new curative interventions. While autopsy-based studies shed some light on several pathological events that are believed to be crucial in the development of this neurologic syndrome, their investigative potential is limited and has not allowed the identification of causes of death in patients who succumb to it. This can only be achieved by comparing features between patients who die from cerebral malaria and those who survive. In this review, several alternative approaches recently developed to facilitate the comparison of specific parameters between fatal, non-fatal cerebral malaria and uncomplicated malaria patients are described, as well as their limitations. The emergence of neuroimaging as a revolutionary tool in identifying critical structural and functional modifications of the brain during cerebral malaria is discussed and highly promising areas of clinical research using magnetic resonance imaging are highlighted.
    Malaria Journal 07/2014; 13(1):276. DOI:10.1186/1475-2875-13-276 · 3.11 Impact Factor
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    • "The microscopic techniques Orthogonal Polarization Spectral (OPS) imaging [1] and is successor Sidestream Dark Field (SDF) imaging [2] enable visualization of the microcirculation. The technique is available as a hand held device. "
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    ABSTRACT: Background Since analysis of Sidestream Dark Field images still requires subjective interpretation, we wanted to determine intra-observer repeatability and to estimate the correlation between different evaluation methods. Methods Fifty-four Sidestream Dark Field videos were analyzed twice by the same blinded observer using validated software. Vessels were detected, generating the parameter Total Vessel Density (TVD), and flow was determined by (i) classifying each vessel separately, generating the parameters Perfused Vessel Density (PVD) and Proportion of Perfused Vessels (PPV), and by (ii) the “Boerma” method, generating a Microvascular Flow Index (MFI) by quadrants. Results Intraclass Correlation Coefficients (ICCs) were above 0.9 for TVD and above 0.8 for PDV and PPV. MFIby quadrants had the lowest reliability (ICC = 0.52 for capillaries and ICC = 0.59 for all vessels), significantly lower than for PVD (ICC = 0.89, p < 0.001 for capillaries and ICC = 0.90, p < 0.001 for all vessels) and PPV (ICC = 0.82, p = 0.003 for capillaries and ICC = 0.83, p = 0.01 for all vessels). Correlation coefficient (r) between PPV and MFIby quadrants corrected for measurement error was 0.39 (0.10 – 0.64) for capillaries and 1.01 (0.85 – 1.16) for all vessels. Conclusions Intra-observer reliability for full evaluation of Sidestream Dark Field images was good for vessel detection and for flow classification but significantly poorer for the faster “Boerma” method. Furthermore, the Boerma method is likely to estimate different aspects of capillary flow than do the standard methods.
    BMC Medical Imaging 05/2014; 14(1):14. DOI:10.1186/1471-2342-14-14 · 1.31 Impact Factor
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