Laser speckle contrast imaging accurately measures blood flow over moving skin surfaces

Cutaneous blood flow (CBF) can be assessed non-invasively with lasers. Unfortunately, movement artefacts in the laser skin signal (LS_sk) might sometimes compromise the interpretation of the data. To date, no method is available to remove movement artefacts point-by-point. Using a laser speckle contrast imager, we simultaneously recorded LS_sk and the signal backscattered from an adjacent opaque surface (LS_os). The completion of a first protocol allowed a definition of a simple equation to calculate the CBF from movement artefact-affected traces of LS_sk and LS_os. We then recorded LS_sk and LS_os before, during and for 5 min after the tourniquet ischemia, both when subjects (n = 8) were immobile or submitted to external passive movements of random intensity throughout the test. The typical post-occlusive reactive hyperemia trace was not identifiable within the LS_sk recordings, with LS_sk being 2 to 3 times higher during movements than in the immobile situation. After the calculation of CBF, traces in the immobile versus movement conditions were comparable, with the “r” cross-correlation coefficient being 0.930+/−0.010. Our method might facilitate future investigations in microvascular physiology and pathophysiology, specifically in subjects who have frequent or continuous involuntary movements.     

The effect of recurrent severe hypoglycemia on cognitive performance in children with type 1 diabetes: a meta-analysis

The purpose of this study was to investigate the existence and extent of cognitive impairment in type 1 diabetic children with episodes of recurrent severe hypoglycemia, using meta-analysis to synthesize data across studies. The meta-analysis sample included: 441 children with diabetes and recurrent severe hypoglycemia, 560 children with diabetes and without recurrent severe hypoglycemia. Overall, children with type 1 diabetes and recurrent severe hypoglycemia had slightly lower performance than diabetic children without severe hypoglycemia, only in some cognitive domains: intelligence, memory, learning, and verbal fluency/language. Greater impairment was found in memory and learning. No impairment was found for motor speed. Our results seem to confirm the hypothesis that recurrent severe hypoglycemia has a selective negative effect on the children's cognitive functions. However, these results must be considered with caution taking into account factors such as small sample sizes, the different definitions of severe hypoglycemia, and the variety of neuropsychological tests used.     

Microvesiculation and cell interactions at the brain–endothelial interface in cerebral malaria pathogenesis

Cerebral malaria (CM) is still a major world health problem whose pathogenic mechanisms remain incompletely understood. After reviewing some particularities of anti-malarial immunity, we focus here on the neurovascular aspects of CM. We specifically address the central role of endothelial activation and alteration in disease pathogenesis. We discuss the respective roles of “mediator-induced” versus “host cell-induced” mechanisms of endothelial alteration. The former include cytokines, chemokines and their receptors, while the latter encompass cells located inside and outside the vessel, notably glial cells. We also present evidence for a pathogenic role for membrane microparticles (MP) in CM, based on studies in African patients and in a recognised mouse model. Intervention studies on MP production, via either gene knockout or pharmacological inhibition, can prevent the neurological syndrome and its associated mortality, suggesting potential new therapeutic avenues.     

Human graft cornea and laser incisions imaging with micrometer scale resolution full-field optical coherence tomography

Micrometer scale resolution full-field optical coherence tomography (FF-OCT) is developed for imaging human graft corneas. Three-dimensional (3-D) images with ultrahigh resolution (respectively, 1 and 1.5 μm in the axial and transverse directions), comparable to traditional histological sections, are obtained allowing the visualization of the cells and the precise structure of the different layers that compose the tissue. The sensitivity of our device enables imaging the entire thickness of the cornea, even in edematous corneas more than 800 μm thick. Furthermore, we provide tomographic 3-D images of laser incisions inside the tissue at various depths without slicing the studied corneas. The effects of laser ablations can be observed, along various optical sections, directly in the bulk of the sample with high accuracy, providing information on the interface quality and also imaging tiny changes of the tissue structure. FF-OCT appears to be a powerful tool for subcellular imaging of the corneal structure and pathologies on the entire thickness of the tissue as well as interface quality and changes in the collagen structure due to laser incisions on ex vivo human cornea.