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Can Oxygen Therapy Improve Brain Blood Vessel Function in COPD Patients?

By Allison Inserro

Breathing in additional oxygen improves the function of blood vessels in the brains of people with chronic obstructive pulmonary disease (COPD), according to research published in Experimental Physiology.

The study revealed that patients with COPD are at higher risk of dementia, possibly because of lower brain oxygen levels as a result of problems with blood supply from brain blood vessels. According to other research cited in the study, giving patients with COPD additional oxygen reduced their risk of developing dementia, but the mechanisms underlying this effect had not been explored.

The latest research aimed to establish the effect of supplying additional oxygen in blood flow to the brain and blood vessel function in patients with COPD. Fourteen hypoxemia patients were included in the study, which tracked cerebral blood flow (CBF), oxygen delivery (CDO2), and neurovascular coupling (NVC), which is the relationship between local neuron activity and changes in CBF.

The researchers used ultrasound to view and measure blood flow in the brain in these patients at rest as well as before and during delivery of the additional oxygen. Ultrasound was used to measure the extent to which brain blood flow increased.

Participants began this test with their eyes shut, then opened them and read a piece of text. This test was designed to increase activity in the brain, and brain blood flow was expected to increase to provide an adequate oxygen supply.

Pairing these ultrasound measures with a measurement of blood oxygen levels allowed authors to estimate how much oxygen delivery to the brain increased during the eyes-open reading test.

Measurements were assessed, and the authors found that blood flow and oxygen delivery to the brain significantly increased during reading because blood vessels in the brain dilated in response to the greater oxygen demand when the brain was active.

Specifically, peripheral oxyhemoglobin saturation increased from 91 ± 3.3 to 97.4 ± 3% (P <.01). CBF was unaltered (593.0 ± 162.8 vs 590.1 ± 138.5 mL min−1; P = .91) with supplemental O2.

However, CDO22 (98.1 ± 25.7 versus 108.7 ± 28.4 ml dl−1; P = 0.02) and NVC improved.

The posterior cerebral artery cerebrovascular conductance increased after O2 normalization (+40%, from 20.4 ± 9.9 to 28 ± 10.4% increase in conductance; P = .04). The posterior cerebral artery cerebrovascular resistance decreased to a greater extent during O2 normalization (+22%, from −16.7 ± 7.3 to −21.4 ± 6.6% decrease in resistance; P = .04).

The cerebral vasculature of patients with COPD appears insensitive to oxygen because CBF was unaltered in response to O2 supplementation, leading to improved CDO2.

Providing extra oxygen to patients with COPD improved the function of blood vessels in the brain by increasing blood supply to meet the demands of the brain’s activity during this short test.

Other research is needed to see how long-term oxygen use would impact the function of brain blood vessels.

These improvements might provide a physiological link between oxygen therapy and a reduced risk of cerebrovascular diseases such as stroke, mild cognitive impairment, and dementia.


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Capillary damage can lead to depression

A direct link has been found between damage to capillaries (microcirculation) and depression. Researchers at Maastricht UMC+ found that microcirculatory damage increases the risk of depression by twenty to fifty per cent. Their findings on the link between microcirculation and depression were recently published in the leading scientific journal JAMA Psychiatry.

Patients with type 2 diabetes – the most prevalent disease worldwide – are twice as likely to develop depression as healthy individuals. Until now, there was no explanation for this link. However, we did know that type 2 diabetes and hypertension damages microcirculation, which is the circulation of blood in the smallest blood vessels. Poor microcirculation is relatively common in adults and does not necessarily have negative consequences, as the body is equipped with physiological reserve capacity. However, if the damage is severe, this can have a negative impact on daily functioning. The capillaries supply oxygen and nutrients to all parts of the body, including the parts of the brain that regulate mood. If this supply is disrupted, it can have a negative effect on our mood.  



The researchers based their findings on a literature study and their own microcirculatory measurements obtained through MRI imaging, biomarkers in the blood and research on the capillary function in the skin and retina. The capillary measurements, carried out as part of The Maastricht Study, were exceptionally tricky. Damage to major blood vessels is relatively easy to determine, but capillaries are hard to study because the slightest movement by the test subject can disrupt the measurement and render it unreliable.


Image translation:
The Maastricht Study: challenges of a healthy lifestyle Measuring microcirculation in the human body.
In the brain, In the eye, Under the tongue; In the skin of the wrist, In the fingertip; In the skin of the ankle.
8000 participants (1800 of which have type 2 diabetes), 40 FTE (23 PhD candidates – 63 internships), 20 million (invested), 36 publications (in scientific journals), 9 publications (in prestigious journals).



The researchers assume that microcirculatory damage can be treated with medication. Certain hypertension medications improve microcirculation to some extent, but a targeted drug for this purpose does not yet exist. Developing one will require further insight into the underlying mechanisms that cause depression. 

Marnix van Agtmaal is currently conducting PhD research on the link between microcirculatory damage and depression. He expects to complete his dissertation in early 2018. The link to the publication in JAMA Psychiatry.


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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Benefit from D’OXYVA’s IDE status

By virtue of the fact that Institutional Review Boards (IRBs) approved human clinical studies with D’OXYVA®  and concluded that it was a Non-Significant Risk (NSR) device, D’OXYVA®  has an approved Investigational Device Exemption (IDE). See 21 CFR 812 reference below in section (b) and (1) highlighted in CAPITAL LETTERS.

This means D’OXYVA can be used for any medical purposes under testing (investigations). Doctors can ask their patients if they would like to try and test D’OXYVA®  for a certain period of time to see if it helps their condition. First, D’OXYVA should be used as an adjunct application combined with other therapies (no negative interference with other modalities has been reported to date). Typically, patients should test D’OXYVA®  for the first time for 6-8 weeks twice a day for the first two weeks and then once a day to achieve best results according to various clinical trial results and user feedback with D’OXYVA® . Severe cases should continue using it twice a day for 4 weeks and then based on progress lower dosing to once a day.

(b) Abbreviated requirements. THE FOLLOWING CATEGORIES OF INVESTIGATIONS ARE CONSIDERED TO HAVE APPROVED APPLICATIONS FOR IDE’S, unless FDA has notified a sponsor under 812.20(a) that approval of an application is required:

(1) AN INVESTIGATION OF A DEVICE OTHER THAN A SIGNIFICANT RISK DEVICE, if the device is not a banned device and the sponsor:

(i) Labels the device in accordance with 812.5;


(iii) Ensures that each investigator participating in an investigation of the device obtains from each subject under the investigator’s care, informed consent under part 50 and documents it, unless documentation is waived by an IRB under 56.109(c).

(iv) Complies with the requirements of 812.46 with respect to monitoring investigations;

(v) Maintains the records required under 812.140(b) (4) and (5) and makes the reports required under 812.150(b) (1) through (3) and (5) through (10);

(vi) Ensures that participating investigators maintain the records required by 812.140(a)(3)(i) and make the reports required under 812.150(a) (1), (2), (5), and (7); and

(vii) Complies with the prohibitions in 812.7 against promotion and other practices.

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Blood Flow Velocity

Each time our heart beats, a specific volume of blood is pumped in and out of the body. Blood gets circulated by systematic opening and closing of the valves, before it finally returns to the heart. Blood circulation takes place under certain pressure and its velocity is dependent on our physical activities and cardiac health. If the rate of blood flow deviates from the normal, then there’s a probability of underlying body ailment. We explain you the nature of blood flow and the factors affecting its velocity over here.

Blood Flow Velocity ~ An Overview

The definition of blood flow velocity as given in the medical dictionary is, “a value equal to the total volume flow divided by the cross-sectional area of vascular bed”. Velocity of blood is measured in cm/s. Blood flows at zero velocity through the vessel walls. Movement of blood inside the body slows down if a person has undergone considerable volume of blood loss. Decrease in rate of flow might also lead to de-oxygenation or starve the vessels of oxygen. People who have suffered heart strokes experience immense decrease in velocity of blood flow. Brain cell death is one of the most severe consequences of extremely retarded blood flow. On the other hand, when high blood velocity is high, it gives rise to several health problems. Vessels under high velocity are more susceptible to breakage and rupture.

Velocity is also dependent on blood pressure. A healthy cardiovascular system has well-balanced blood pressure and velocity. Under such circumstances, a steady state of blood flow is maintained in the body. Changes in blood pressure can alter the rate of flow. Blood velocity is dependent on its surface area of flow and the resistance offered to its path. Larger the surface area of the vessels, greater is the flow rate. Resistance is offered by closing of valves, which leads to decrease in velocity.

The pattern of blood flow is laminar (blood flows linearly and smoothly) under normal conditions. Linear flow is observed in adjacent layers of blood vessels while it flows turbulently in ascending aorta, branch points, stenotic arteries and stenotic heart valves. Turbulence or chaotic flow is felt clearly under a stethoscope. Physiological murmurs generated due to the turbulence is usually perceived during pregnancy and when an individual exercises or performs strenuous physical activities. The cardiac output gets extremely elevated as a consequence of turbulent blood flow. Research on blood velocity has revealed that there is a significant decrease in the velocity when a person is under the influence of alcohol. Studies show that rate of blood flow in the middle cerebral artery is less in heavy drinkers and smokers.

Determining Blood Flow Velocity

Velocity of blood flow is determined by a factor known as Reynolds number (Re). The formula is stated below:

Re = (mean velocity× vessel diameter× blood density)/blood viscosity.

The value of Re is directly proportional to the velocity of blood flow and inversely proportional to the viscosity of blood. Under ideal conditions, i.e., in long, straight and smooth blood vessels, critical Re is relatively high, whereas in branching vessels, critical Re is much lower.

Velocity of blood flow can be measured by two methods, viz., Laser Doppler flow measurement and Ultrasonic (Doppler, transit time) flow meters. In the first process, a monochromatic laser diode is used to measure the rate of blood flow while in ultrasonic techniques, the flow meters measure the difference of the transit time of ultrasonic pulses moving in and against the direction of blood flow.

We can also infer that the velocity of blood defines our health status. Thus, it becomes necessary to maintain a consistency in blood flow and blood pressure for having perfectly sound cardiovascular health.


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Breaking News from the Surabaya Vascular Update 2015

Circularity Healthcare Launches Clinical Trials, Business Initiatives with Influential Experts Across the Region

Legal Disclaimer:
No association or collaboration whatsoever is implied or expressed between InvisiDerm Healthcare and the organizers of SURVUE 5 2015 in the following content. The opinions and statements found herein, expressed or implied constitute the sole private initiatives of InvisiDerm Healthcare and InvisiDerm Healthcare takes full responsibility for their accuracy and completeness.
SURVUE 5 2015 was organized by leading doctors from thoracic, cardiac, and vascular faculty department of Kedukteran Universitas Airlangga Surabaya, Indonesia. Their 5th conference was held to discuss vascular updates on March 6 – 8, 2015 at RSUD Dr. Seotomo Hospital.
Circularity’s CEO, Norbert Kiss and Senior Sales and Marketing Manager, Jennifer Rose Boadilla were invited by Professor Puruhito, the organizer of the event and got the chance to meet some of the most influential thoracic, cardiac, vascular, and wound care experts in Indonesia at the this event.
The event was professional and had high level of participation. The speakers included experts from France and Germany and all presentations were high quality and informative showcasing the latest in technologies and approaches to thoracic, cardiac, and vascular surgery.

With the personal introductory presentation of D’OXYVA by Prof. Puruhito, Circularity’s CEO, Norbert Kiss delivered two presentations of 30 minutes each on two separate days to the attending doctors about the importance of measuring and improving microcirculation, the latest research in the field, and the various clinical evidence of D’OXYVA for unmatched improvements of microcirculation, related physiological functions, and their benefits in humans coupled with case studies.

We are glad to announce that Circularity has secured some of the most influential thoracic, cardiovascular, and wound care medical thought-leaders from Indonesia via strategic relationships at this event. Participation in our comprehensive multicenter, multicountry study coupled with advanced diagnostics for diabetic foot wound healing on hundreds of subjects at leading hospitals is being expanded to Indonesia. Attending doctors discussed in private meetings with Circularity initiating studies and the potential significant benefits of D’OXYVA for pre-, and post-operative vascular applications, cerebrovascular disease, and ischemic heart disease, which is the most common cause of death in most western countries.

Circularity’s affordable, safe, and fast applications for a wide variety of significant clinical outcomes make it clearly a leader in a number of aspects if not most based on the feedback received.

With the help of PT Regenesis, we had a chance to showcase D’OXYVA’s use and debut our new catalog with an exhibit booth to participants of this event. Special thanks to PT Regenesis for their warm hospitality.