Refine
Has Fulltext
- yes (4)
Is part of the Bibliography
- no (4)
Keywords
- BFIS (1)
- Energiebereitstellung (1)
- Energieumsatz <Medizin> (1)
- Entzündung (1)
- Gewebedurchblutung (1)
- Gewebetemperatur (1)
- Infektionsabwehr (1)
- Infrarot (1)
- Infrarot-Thermographie (1)
- Lebensqualität (1)
- PKD (1)
- PKD/IC (1)
- PRRT2 (1)
- Problemwunden (1)
- Sauerstoff (1)
- Sauerstoffpartialdruck im Gewebe (1)
- Sauerstoffversorgung (1)
- Schmerz (1)
- Schmerzminderung (1)
- Thermographie (1)
- Ulcus cruris venosum (1)
- Wunde (1)
- Wundheilung (1)
- Wundinfektion (1)
- Wundinfektionen (1)
- Wundsekretion (1)
- chronic venous stasis ulcers of the lower legs (1)
- chronic wounds (1)
- chronische Wunden (1)
- chronische venöse Unterschenkel-Ulzera (1)
- energy supply (1)
- familial infantile epilepsy (1)
- hemiplegic migraine (1)
- infection defense (1)
- inflammation (1)
- infrared thermography (1)
- oxygen supply (1)
- phenotypic spectrum (1)
- problem wounds (1)
- prospective, randomized, controlled, blinded study (1)
- prospektive, randomisierte, kontrollierte, verblindete Studie (1)
- quality of life (1)
- reduction of pain (1)
- temperaturabhängige und temperaturunabhängige Effekte (1)
- thermal and non-thermal effects (1)
- thermic and non-thermic effects (1)
- thermische und nicht-thermische Effekte (1)
- thermographic image analysis (1)
- thermographische Bildanalyse (1)
- tissue blood flow (1)
- tissue oxygen partial pressure (1)
- tissue temperature (1)
- visual analog scales (VAS) (1)
- visuelle Analogskalen (VAS) (1)
- wassergefiltertes Infrarot A (wIRA) (1)
- water-filtered infrared-A (wIRA) (1)
- wound exudation (1)
- wound healing (1)
- wound infections (1)
Institute
- Medizin (1)
- Sportwissenschaften (1)
The central portion of chronic wounds is often hypoxic and relatively hypothermic, representing a deficient energy supply of the tissue, which impedes wound healing or even makes it impossible. Water-filtered infrared-A (wIRA) is a special form of heat radiation with a high tissue penetration and a low thermal load to the skin surface. wIRA produces a therapeutically usable field of heat and increases temperature, oxygen partial pressure and perfusion of the tissue. These three factors are decisive for a sufficient tissue supply with energy and oxygen and consequently as well for wound healing, especially in chronic wounds, and infection defense. wIRA acts both by thermal and thermic as well as by non-thermal and non-thermic effects. wIRA can advance wound healing or improve an impaired wound healing process and can especially enable wound healing in non-healing chronic wounds. wIRA can considerably alleviate the pain and diminish wound exudation and inflammation and can show positive immunomodulatory effects.
In a prospective, randomized, controlled study of 40 patients with chronic venous stasis ulcers of the lower legs irradiation with wIRA and visible light (VIS) accelerated the wound healing process (on average 18 vs. 42 days until complete wound closure, residual ulcer area after 42 days 0.4 cm² vs. 2.8 cm²) and led to a reduction of the required dose of pain medication in comparison to the control group of patients treated with the same standard care (wound cleansing, wound dressing with antibacterial gauze, and compression garment therapy) without the concomitant irradiation.
Another prospective study of 10 patients with non-healing chronic venous stasis ulcers of the lower legs included extensive thermographic investigation. Therapy with wIRA(+VIS) resulted in a complete or almost complete wound healing in 7 patients and a marked reduction of the ulcer size in another 2 of the 10 patients, a clear reduction of pain and required dose of pain medication, and a normalization of the thermographic image.
In a current prospective, randomized, controlled, blinded study patients with non-healing chronic venous stasis ulcers of the lower legs are treated with compression garment therapy, wound cleansing, wound dressings and 30 minutes irradiation five times per week over 9 weeks. A preliminary analysis of the first 23 patients of this study has shown in the group with wIRA(+VIS) compared to a control group with VIS an advanced wound healing, an improved granulation and in the later phase of treatment a decrease of the bacterial burden.
Some case reports have demonstrated that wIRA can also be used for mixed arterial-venous ulcers or arterial ulcers, if irradiation intensity is chosen appropriately low and if irradiation is monitored carefully. wIRA can be used concerning decubital ulcers both in a preventive and in a therapeutic indication. wIRA can improve the resorption of topically applied substances also on wounds.
An irradiation with VIS and wIRA presumably acts with endogenous protoporphyrin IX (or protoporphyrin IX of bacteria) virtually similar as a mild photodynamic therapy (endogenous PDT-like effect). This could lead to improved cell regeneration and wound healing and to antibacterial effects.
In conclusion, these results indicate that wIRA generally should be considered for the treatment of chronic wounds.
Pathogenic variants in PRRT2, encoding the proline-rich transmembrane protein 2, have been associated with an evolving spectrum of paroxysmal neurologic disorders. Based on a cohort of children with PRRT2-related infantile epilepsy, this study aimed at delineating the broad clinical spectrum of PRRT2-associated phenotypes in these children and their relatives. Only a few recent larger cohort studies are on record and findings from single reports were not confirmed so far. We collected detailed genetic and phenotypic data of 40 previously unreported patients from 36 families. All patients had benign infantile epilepsy and harbored pathogenic variants in PRRT2 (core cohort). Clinical data of 62 family members were included, comprising a cohort of 102 individuals (extended cohort) with PRRT2-associated neurological disease. Additional phenotypes in the cohort of patients with benign sporadic and familial infantile epilepsy consist of movement disorders with paroxysmal kinesigenic dyskinesia in six patients, infantile-onset movement disorders in 2 of 40 individuals, and episodic ataxia after mild head trauma in one girl with bi-allelic variants in PRRT2. The same girl displayed a focal cortical dysplasia upon brain imaging. Familial hemiplegic migraine and migraine with aura were reported in nine families. A single individual developed epilepsy with continuous spikes and waves during sleep. In addition to known variants, we report the novel variant c.843G>T, p.(Trp281Cys) that co-segregated with benign infantile epilepsy and migraine in one family. Our study highlights the variability of clinical presentations of patients harboring pathogenic PRRT2 variants and expands the associated phenotypic spectrum.