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Venous leg ulcer prevention: Identifying patients who are at risk

Abstract

Ulceration of the lower limbs results in painful and often debilitating leg wounds that can have a profound effect on patients’ physical, social and psychological wellbeing. It is estimated that the UK spends nearly £2bn each year managing lower limb ulceration but NHS England has highlighted that the care patients receive is often sub-optimal and unwarranted variation results in higher costs and longer healing times. Rates of non-healing are both common and costly, which adds to the burden on patients and the healthcare system. The prevalence of leg ulceration is higher in older age groups and, as our population ages, the problem is likely to increase. All nurses have a vital role in identifying patients at risk of ulceration and supporting them to take preventative action to prevent skin breakdown. This article, the first in a three-part series on the prevention of leg ulceration, looks at how nurses can identify at-risk patients.

 

Introduction

Lower-leg ulceration affects around 1.5% of adults in the UK, with 730,000 people having often painful and debilitating leg wounds (Guest et al, 2015). Prevalence is highest among people aged 60-80 years, and increases with age (Farah and Davis, 2010), so the ageing population signals a growing problem.

Approximately 70% of lower-leg ulceration relates to venous disease (Casey, 2004), a debilitating condition affecting millions of people worldwide (O’Donnell et al, 2014). Varicose veins are often a first sign of venous disease and are a predictive factor in developing ulceration (Robertson et al, 2011) (Fig 1). The incidence of varicose veins in the adult population ranges from 10% to 60% worldwide (Selçuk Kapısız et al, 2014), and is estimated at 36% in the UK (Robertson, 2013; Evans et al, 1999).

Conclusion

Compression therapy has an important role to play in the prevention of leg ulceration but a greater emphasis on prevention is needed if the considerable burden of managing leg ulceration is to be reduced. Nurses should actively assess patients’ legs for signs of venous disease and oedema, and undertake opportunistic assessment whenever possible. Ensuring appropriate early intervention will improve patient outcomes and result in significant cost savings to health services.

Key points

*Lower-leg ulceration affects 1.5% of adults in the UK, and an ageing population means the number is likely to grow
*Prevention and management are often sub-optimal, leading to non-healing and a near doubling of patients each year
*Venous leg ulceration is the most severe manifestation of chronic venous disease caused by venous hypertension
*Skin changes are the biggest predictor of ulceration, with lower-limb oedema also being a risk
*Nurses need to spot the early signs of venous leg ulceration and take preventative action, such as using compression therapy

Reference: https://www.nursingtimes.net/clinical-archive/tissue-viability/venous-leg-ulcer-prevention-1-identifying-patients-who-are-at-risk/7029100.article

HOW D’OXYVA CAN HELP?

D’OXYVA® (deoxyhemoglobin vasodilator) has eliminated 97%* of all mild to severe so-called spider and varicose veins for both men and women users. Doing so while eliminating associated long-term pain within 2 to 4 weeks** by taking a single 5-minute application 5 times per week.

The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.

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Circularity Healthcare Negotiating $100 million Institutional Funding, Expands Successful D’OXYVA Phase 3 Diabetic Foot Ulcer Treatment Clinical Trials, Expects Fast-Track FDA Approval

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[Los Angeles, CA, July 16, 2019] Circularity Healthcare LLC, developer and manufacturer of transdermal drug delivery and wound healing products, has announced that the company has entered into negotiations with institutional investors to inject up to $100 million in growth capital into the company. The capital is to be used to drive Circularity’s launch of product sales in collaboration with several global multinational partners, with a target of several hundred million dollars. The company’s overarching fundraising goal is to access public equity markets through a multibillion-dollar U.S. IPO in the near future.

Privately-held, Los Angeles-based Circularity Healthcare is capitalizing on its completed successful and expanded Phase 3 clinical studies led by prominent researchers, such as Prof. David Armstrong, Prof. Ito Puruhito and Dr. Felix Sigal, and leading institutions, such as MIT, Airlangga, Harvard, Yale, University of Texas at Arlington, and many others. The clinical studies are expected to lead to the company’s highly anticipated Food and Drug Administration FDA approval as a non-significant risk (NSR) combination drug-device for the rapid and highly effective treatment of diabetic foot ulcers.

These exciting developments come on the heels of the rapidly growing market demand for Circularity’s existing product line with a proven technology, manufacturing and fulfillment base. Circularity has recently begun production of its unique, branded, pharmaceutical-grade platform drug molecules.

Already well positioned as an emerging global biotech and medtech product manufacturer, Circularity is now shifting more focus from its non-regulated wellness and cosmetic products to its premium FDA-approved patented and patent-pending drug solutions. These solutions are delivered with the company’s patented and patent pending, non-invasive and painless, rapid transdermal drug delivery systems. The expanded focus is due to Circularity’s exceptionally positive Phase 3 multicenter, multicountry, and multiyear human clinical trials on diabetic foot ulcers, as well as its overall regulatory development path.

Recently, the company launched sales of MicroScan, a clinical diagnostics tool with an installed base at intensive care units (ICU) in 35 countries worldwide. MicroScan enables Circularity to generate much higher average revenue per customer, while providing highly affordable insights, both for patients and health professionals, into the inner workings and mechanisms ofactions underpinning the exceptional clinical outcomes of Circularity’s flagship D’OXYVAproduct line. Until recently, D’OXYVA was available only under test-marketing programs. Together with the diagnostic tools, health experts implementing D’OXYVA can accurately predict wound healing and other major clinical outcomes, such as achieving healthy blood sugar or blood pressure.

Once D’OXYVA has helped the patient achieve healthy levels in such key areas, physicians typically recommend a less frequent dosing schedule in order to remain symptom-free long-term.

During the past seven years, Circularity has assembled a world-class clinical research, regulatory and legal team comprised of several dozen experts mainly from the U.S. and from several influential European and Asian countries for its comprehensive global market development.

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Mental health crisis hotline launched in the Philippines

Amid the rising suicide prevalence in the country, the Department of Health (DOH) yesterday launched a mental health crisis hotline aimed at helping curb the problem.

Health Secretary Francisco Duque III said the National Center for Mental Health (NCMH) crisis hotline will operate 24/7 to provide counseling for those at risk of committing suicide and other people suffering from mental health conditions.

The new NCMH crisis hotline can be reached at 0917-899 8727 or 989-8727.

“Everyone is enjoined to support the dissemination of the hotline numbers,” Duque said as he noted the many lives that can be saved with the use of the hotline.

Duque said mental illness is a major public health concern in the country, with many patients reluctant to seek medical treatment due to stigma.

He said without the proper necessary intervention, many of those who are suffering from mental conditions take their own lives.

Data showed that 3.2 percent of every country’s population is likely to commit suicide.

Studies indicated that suicide is the second leading cause of death among people aged 29 to 59 years old worldwide.

The Goulbourn Foundation, which also operates a 24-hour suicide prevention hotline in coordination with the DOH, reported that three young people committed suicide last week.

The foundation said the youngest suicide victim they have recorded was a seven-year-old child.

There is still no available data on the national prevalence of mental illness in the Philippines, but the DOH said a study is underway to determine the extent of the problem.

Duque said records from the NCMH showed the government-run institution has an average of 7,500 in-patients and serves up to 65,000 outpatients annually.

“The NCMH figure could be an indicator of the gravity of mental health problem in the country,” he said.

Duque expressed optimism that the health problem could be addressed with the implementation of the Mental Health Act.

He said the law mandates the DOH to develop a national suicide prevention strategy, which now includes the establishment of the NCMH crisis hotline.

NCMH officer-in-charge Allan Troy Baquir said the hotline would help people who are experiencing anxiety and depression as well as health workers who need guidance in handling their patients with mental illness.

Operating on a P7-million budget, the hotline will assess the needs of the callers and refer them to proper specialist or medical facilities if necessary.

Also yesterday, the DOH launched programs under the Kalusugan at Nutrisyon ng Mag-Nanay Act.

The new program aims to boost children’s health and reduce stunting and malnutrition.

Duque said the DOH would provide pregnancy and after birth medical services to both mothers and infants.

HOW D’OXYVA CAN HELP?

D’OXYVA is the only fully noninvasive, completely painless transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation.

The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.

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Diabetes, cardiovascular disease and the microcirculation

Abstract

Cardiovascular disease (CVD) is the leading cause of mortality in people with type 2 diabetes mellitus (T2DM), yet a significant proportion of the disease burden cannot be accounted for by conventional cardiovascular risk factors. Hypertension occurs in majority of people with T2DM, which is substantially more frequent than would be anticipated based on general population samples. The impact of hypertension is considerably higher in people with diabetes than it is in the general population, suggesting either an increased sensitivity to its effect or a confounding underlying aetiopathogenic mechanism of hypertension associated with CVD within diabetes. In this contribution, we aim to review the changes observed in the vascular tree in people with T2DM compared to the general population, the effects of established anti-diabetes drugs on microvascular outcomes, and explore the hypotheses to account for common causalities of the increased prevalence of CVD and hypertension in people with T2DM.

Background

Type 2 diabetes mellitus (T2DM) and hypertension are established risk factors for cardiovascular disease (CVD), and people with T2DM and hypertension have an increased risk of cardiovascular (CV) mortality compared with those with either condition alone. This excess risk is suggested to be due to the synergistic effect on large and small blood vessels simultaneously, thereby reducing the potential for compensatory collateralization protecting organs from the adverse consequences of damage to either vascular bed. The principle role of the vasculature is to deliver oxygen and nutrients to the tissues—whether that is the heart, the brain, or the kidney. The functional changes occurring in T2DM and hypertensive conditions significantly alter the haemodynamic stress on the heart and other organs. However, the different physiology, mechanisms and changes at the microvascular level differ from those at the macrovascular level in T2DM and hypertension, which in turn have significant implications with respect to future CV risk.

Conclusions

Over the past few decades, epidemiological studies have elucidated the role of impaired microcirculation in people with diabetes and aetiopathogenesis of CVD. This has led to the recognition of the prevalence of microvascular disease. Furthermore, the prognostic value of incidence of microvascular disease in predicting CVD is now acknowledged. The focus of present-day epidemiological studies is to understand the association between pathological mechanisms and the risk factors to ascertain whether they are targets of therapeutic value or risk markers of CVD. These studies have contributed to the evidentiary framework in favour of clinical monitoring of microvascular function, and spurred the initiation of mechanistic studies by redefining our knowledge of vascular disease, particularly in people with diabetes.

HOW D’OXYVA CAN HELP?

Over the past few decades, epidemiological studies have elucidated the role of impaired microcirculation in people with diabetes and aetiopathogenesis of CVD. D’OXYVA is the only fully noninvasive, completely painless transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation.

The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.

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Older adults more likely to develop dementia after a concussion, Canadian study finds

dementia

Older adults are much more likely to develop dementia after experiencing a concussion, according to a large new Canadian study. But the researchers also found this risk may be modestly reduced by taking a certain group of cholesterol-lowering drugs.

The study, published on Monday in the journal JAMA Neurology, found one in six Ontarians, ages 65 and older, were diagnosed with dementia within an average of four years after suffering a concussion. That was double the rate for the rest of the population.

The study, however, found that concussion patients who took statins, a class of drugs commonly used to prevent heart disease, had about 10 to 15 per cent lower risk of dementia than those who did not.

While this suggests statins may help patients’ brains recover after a concussion, the findings underscore the importance of protecting one’s brain in the first place, says lead investigator Donald Redelmeier, a senior scientist at ICES (formerly the Institute for Clinical Evaluative Sciences).

“More prevention of concussion is justified, not just in exuberant young athletes, but throughout the lifespan,” says Dr. Redelmeier, who is also a physician at Toronto’s Sunnybrook Health Sciences Centre and a professor of medicine at the University of Toronto.

The study adds to growing evidence linking concussions to the development of dementia. In a separate study published last year in JAMA Neurology, for example, U.S. researchers examining more than 350,000 military veterans similarly found they were two times more likely to develop dementia after experiencing a concussion.

One of the researchers of that earlier study, Kristine Yaffe, a professor of psychiatry and neurology at the University of California San Francisco, says scientists do not fully understand why concussions may lead to dementia. One possible explanation is that the injuries may accelerate brain aging and the accumulation of abnormal proteins, such as tau and amyloid, which cause damage to neurons, she says.

In the new study published on Monday, Dr. Redelmeier and his team examined data from 1993 to 2013 for nearly 29,000 Ontarians, age 65 and older, who were not previously diagnosed with dementia before suffering a concussion. They found more than 4,700 of them developed dementia over a minimum follow-up period of three years.

Patients who were prescribed a statin within 90 days of having a concussion had about a 13 per cent lower risk of dementia, compared with those who were not.

Dr. Redelmeier says patients who were on statins were taking the drugs incidentally, for reasons unrelated to their concussion, and most were taking the drug before and after their injury. The researchers found other medications, including other cardiovascular drugs and neuropsychiatric medications, did not appear to make a difference to patients’ risk of dementia.

Based on experimental models, statins can mitigate injury-related brain swelling, inflammation, and faulty microcirculation, affecting the tiniest vessels of the brain, Dr. Redelmeier says, explaining this may be why statins appear to offer some protection against dementia after a concussion.

He points out that one of the main limitations of his study is that it was not a randomized trial, so it could not show whether statins actually caused a lower dementia risk. However, he says, patients using statins tend to start off with more risk factors for dementia prior to having a concussion, so his study may, in fact, underestimate the potential benefits of the drugs.

“There may be a role for actually beginning a statin in the immediate aftermath of a concussion,” provided it is appropriate based on a patient’s age and health, Dr. Redelmeier says. But, he says, it is yet unclear how long patients would need to stay on the drug to reduce their dementia risk.

“If you’re already on a statin and unfortunate enough to have a concussion, keep taking your statin,” he advises.

More importantly, he adds, people should take precautions against brain injury: “So that means driving safely, walking mindfully, using protective gear, staying sober and staying away from risky situations.”

 

HOW D’OXYVA CAN HELP?

D’OXYVA is the only fully noninvasive, completely painless transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation. According to a study published in Alzheimers Association,  improvement in cerebral blood supply and microcirculation promotes remission in Alzheimer’s disease.

The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.

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Under Armour developing ‘smart’ sneaker that reads blood pressure

Under ArmourOpens a New Window. is developing a “smart” sneaker that would track the blood pressure of its wearer, according to a patent filing this week.

The sports apparel brand’s filing with the U.S. Patent and Trademark Office details two versions of a sneaker currently in development. The first version of the sneaker would link to a wearable device and transmit blood pressure that would then be used to adjust the sneaker’s fit for optimal blood flow. The second version of the sneaker contains a “blood pressure detector.”

In the patent filing, Under Armour said the sneaker is meant to help its wearer recover after a “strenuous workout.”

“There exists a need for a device and method to effectively pump blood through the plantar venous plexus and support recovery after engaging in athletic activity,” the company wrote in its filing, dated June 25.

Under Armour representatives did not immediately respond to a request for comment. Baltimore Business Journal was first to report on the filing.

The filing comes as Under Armour and other sports apparel companies seek to integrate technology into their products.

The Baltimore-based company unveiled its first smart shoe, the “HOVR Connected Series,” in 2018. The footwear line measures a runner’s gait and other workout data.

HOW D’OXYVA CAN HELP?

D’OXYVA is the only fully noninvasive, completely painless transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation. 

D’OXYVA promotes benefits related to significantly improved blood circulation, including significantly increased cardiac activity, physical fitness, metabolism, endurance, energy balance and a healthy weight by significantly improving Microcirculation that is detectable real-time with high quality diagnostics.

The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.

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The Alzheimer’s-blood pressure connection

Rock legends David Bowie and Freddie Mercury must have known something that science discovered only recently. In their rock anthem “Under Pressure,” they crooned: “Pressure pushing down on me … Chipping around, kick my brains around the floor.”

Researchers wouldn’t put it quite that way, but there is a correlation between a person’s elevated blood pressure later in life and brain health, particularly Alzheimer’s disease risk. A study in Neurology recorded the blood pressure of 1,300 people ages 59 to 102 annually for a mean of eight years. Brain autopsies of deceased subjects then revealed a link between high blood pressure and the presence of neurofibrillary tangles, characteristic of Alzheimer’s disease.

An elevated systolic, or top number, above 134 mmHG increased the odds of developing brain lesions by nearly 50%. But according to Dr. Richard Isaacson, director of the Alzheimer’s Prevention Clinic at Weill Cornell Medicine and New York-Presbyterian, anything above 120 puts you in the “new risk zone.” The study didn’t find a correlation with an elevation of the diastolic (the bottom number) and Alzheimer’s.

The good news: Lifestyle changes can help you achieve a healthy blood pressure of around 120/75. The DASH, Mediterranean and “What to Eat When” diets are a smart starting point. Check out Sharecare.com for info on these nutritional approaches and to download a free phone app to keep track of your numbers. Plus, ask your doc about medications and at-home, self-measured blood pressure monitors; the cuff ones are usually reliable, but should be checked against one at your doc’s office.

HOW D’OXYVA CAN HELP?

D’OXYVA is the only fully noninvasive, completely painless transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation.

The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.

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Trump Ready To Force Transparency In Healthcare Pricing With An Executive Order

The Trump Administration wants to make it easier for patients and employers to comparison shop for healthcare. On transparency, one can’t fault the Administration for not trying.

So far, the measures implemented have mostly been baby steps. But, this is about to change as President Trump is expected to soon release an executive order on healthcare price transparency. If enacted, this executive order would mandate disclosure of prices throughout the healthcare industry, and be enforceable by federal agencies. It would provide patients and employers pricing data that reflect the negotiated rates between insurers, hospitals, and physicians.

In the lead-up to this week’s expected announcement on the executive order, the Trump Administration has been gradually chipping away to uncover the murky world of healthcare pricing. For example, in October 2018, President Trump signed two bills into law, the Know the Lowest Price Act and the Patients’ Right to Know Drug Prices Act. These bills removed pharmacy gag clauses, imposed by pharmacy benefit managers, which had prevented pharmacists from proactively telling consumers if their prescription would cost less if they paid for it out-of-pocket rather than using their insurance plan.

And, this month, the Department of Health and Human Services (HHS) announced that direct-to-consumer (DTC) advertisements of prescription drugs on television will soon be required to include price information.

Nonetheless, the pharmacy gag clause bills and requirement to include list price information in DTC advertisements only incrementally address prescription drug price transparency. A much bigger step would be to overhaul the prescription drug rebate system, as proposed by HHS. However, it’s unclear whether and when that will happen.

Ultimately, drug price transparency alone won’t be sufficient to create conditions conducive to a competitive market. It needs to be coupled with dissemination of information on which medications are the most effective for specific conditions or diseases. There have been a number of efforts in the commercial sector to address this issue; MedSavvy, for example, which is a Cambia Health Solutions company. Regence Blue Cross and Blue Shield offers MedSavvy to its customers. The federal government is also supporting initiatives to improve the Patient-Centered Outcomes Research Institute’s publication of usable information on comparative effectiveness to consumers. But it’s been a very slow process with few tangible results thus far.

The Trump Administration has also focused on disseminating information regarding the quality of physician practices that serve Medicare beneficiaries. The Centers for Medicare and Medicaid Services (CMS) established a website called Physician Compare. However, nearly 80% of physicians aren’t included in the website database. Reporting is voluntary, and so there’s selection bias when it comes to the performance data that do appear. Moreover, the website doesn’t include a comparison of fees for physician services.

Beginning January 1st this year, the federal government is requiring every hospital in the U.S. to post lists of prices of services and technologies online. Such lists are known in the industry as “chargemasters” that comprise of prices of thousands of services and products for which a hospital may bill.

But, CMS acknowledges it is not yet enforcing the hospital pricing rule. Furthermore, implementation of the rules has sparked a debate about whether the price lists are creating more confusion than clarity among patients. Services and products are identified in acronyms, abbreviations, billing codes, and medical terminology that most consumers can’t be expected to understand.

Additionally, the chargemaster lists don’t normally reflect actual transaction charges because hospitals and insurers generally negotiate significantly lower prices. And, hospitals and insurers are resisting public disclosure of negotiated prices. This week’s expected announcement of an executive order may make such resistance a moot point.

Most patients don’t comparison shop for medical care. Some might not be in a position to do so. Others may simply balk. Perhaps this is due in large part to patients not being used to comparison shopping, or to the opaque character of pricing in the healthcare system. As more useful information becomes available, perhaps patients will begin to do more comparison shopping. which in turn will lead to a more competitive market.

HOW D’OXYVA CAN HELP?

D’OXYVA is the only affordable, fully noninvasive, completely painless transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation.

The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.

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My Neuropathy Story: This Is How My Diabetic Neuropathy Disappeared Forever

“I was first diagnosed with diabetes at a young age,” said Bryan, 50 years old. It was in his early 20s that he started to live with devastating pain in his legs from diabetic neuropathy and had deteriorating muscular degeneration. But today, Bryan can go jogging again, and even his vision is somewhat improving.

 

What happened?

“It’s simple, I started to look at my diet, did more research and found a new solution called D’OXYVA,” said Bryan.

 

Before D’OXYVA

Bryan was diagnosed with type 1 diabetes around 30 years ago. “I couldn’t believe when my doctor told me that my blood sugar levels are high,” he said, although he admitted that other risk factors were obvious, such as being overweight and the fact that diabetes runs in his family.

He ignored his diagnosis and paid little attention to diabetes. He was told to start eating healthy, yet he continued eating what he wanted and didn’t watch his weight.

“A few years ago, I started to feel tingling in my right foot, and it got worse day after day,” said Bryan. Soon, both feet felt numb and he began to feel the pain. It was so painful that he had a hard time taking a step.

At a routine checkup, his doctor wasn’t very happy with him ignoring his diabetes. His doctor told him that his blood glucose was dangerously erratic. From that time on, he became meticulous with managing his diabetes. He started using an insulin pump and other expensive technologies that he thought could help him. But despite all his efforts, Bryan’s health continued to decline, and the pain became more devastating. Despite his eye doctor’s best efforts, Bryan’s macular degeneration was not improving.

 

A solution called D’OXYVA

Bryan decided to do some research on his own. He remembered a patient he was sitting beside in the clinic talking about a product he had had success with. The product was called D’OXYVA.

From his research, he found out that microcirculatory dysfunction renders the diabetic foot unable to mount a vasodilatory response under conditions of stress, such as injury, and makes it functionally ischemic, even in the presence of satisfactory blood flow under normal conditions. Therefore, improving microcirculation to his feet would help with pain management and avoid further nerve damage.

 

D’OXYVA is noninvasive and uses an FDA-approved pharmaceutical-grade CO2. Additionally, it is a clinically validated blood flow and nerve stimulant for people suffering from neuropathy. In various clinical trials, D’OXYVA has been validated and demonstrated above-average results in improving a host of physiological functions at the same time.

 

It’s never too late to start a new journey

“I started off with their pro health set, and strictly followed twice a day D’OXYVA therapy as advised by their therapy expert after requesting for a customized treatment plan. They were very accommodating and professional. After 6 weeks, not only did the product help ease the pain, it got rid of the numbness. Plus, it didn’t cause side effects. My eye doctor also said he sees improvement in my vision,” said Bryan.

Now, Bryan and his wife are both in continuous D’OXYVA therapy as they found out that D’OXYVA, due to its microcirculatory enhancement capability, can help her with her varicose veins.

“I can’t wait to see how I will improve more after a few more months of using D’OXYVA,” Bryan said. He feels a new sense of vitality. He is now back on his feet, living free from the pain of diabetic neuropathy, and has better control of his blood sugar than he has ever had. He and his wife are looking forward to enjoying an active retirement full of exciting adventures and activities, including spending more time with their children and grandchildren.

“I see a new life and a new hope out there for you and for everyone who is experiencing the same,” said Bryan.

HOW D’OXYVA CAN HELP?

D’OXYVA® (deoxyhemoglobin vasodilator) is a novel, clinically validated blood flow and nerve stimulant for people suffering from neuropathy. In various clinical trials, D’OXYVA has validated leading independent research results and demonstrated above-average results in improving a host of physiological functions at the same time.

Subjects suffering from high blood sugar have reported neuropathy pain relief minutes after D’OXYVA was administered and long-term blood sugar level improvements in just a few weeks.

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Vaginal Microcirculation: Non-Invasive Anatomical Examination of the Micro-Vessel Architecture, Tortuosity and Capillary Density

Aim
To describe the vaginal microcirculatory architecture and capillary density parameters using side stream dark field imaging (SDFI), and determine feasibility and reliability of this method.
 
 
Methods
In nine healthy female volunteers SDFI measurements were performed at two different time points in the luteal phase of the menstrual cycle. Non-invasivetissue micro-angioarchitecture and vaginal capillary density measurements were assessed independently by two observers. Agreement was expressed with mean differences between the measurements of both observers and the limits of agreement. Inter- and intra-observer agreement was quantified with the intra-class  orrelation coefficient (ICC).
 
 
Results
Vaginal microcirculatory assessment with the SDFI device was easy in use, painless and well accepted by theparticipants. Morphologically, the vaginal microcirculation revealed an array of single hairpin-shaped capillary loopsdistributed homogeneously across an imaged tissue segment. The intra-observer assessment of the capillary densitymeasurements (comparing two measurement time points of one observer) showed good agreement with an ICC ranging from 0.62 to 0.85. The inter-observer assessments of the capillary density measurements (comparing assessments of two observersaton etimepoint)revealed very good agreement, with small differences between observers and an ICC of more than 0.9.
 
 
Conclusions
This is the first report on both microcirculatory architecture and quantitative microcirculatory parameters of the vagina with the use of SDFI. Micro-vessels of the vagina show a recognizable pattern in our study population of young, healthy women. SDFI gives a reproducible assessment of the vaginal microcirculation offering the researcher a wide field of applications.
 

HOW D’OXYVA CAN HELP?

D’OXYVA is the only fully noninvasive, completely painless transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation.


The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.