Tag: wound healing

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Have you heard of Tere’s inspiring diabetic story?

“My Doctor told me I have less than a year to live if I won’t let them amputate my leg, but I didn’t let them . . . here’s how I am still alive now!”

When doctors initially told 60-year-old Theresa “Tere” Schaufer that she had diabetes, she went into denial for 20 years.

“I was diagnosed with diabetes 20 years ago, and only when my doctor told me that they needed to cut my leg, did I realize that my diabetes was serious,” she says.

 

A major contributing factor

“Doctors told me the only way to survive this fight was to amputate my leg,” Schaufer says.  

She acknowledges that she had lived an unhealthy lifestyle for many years. Working in a restaurant as a cashier, she did very little exercise, ate fast food and drank sodas on a regular basis.

“If the doctor tells you you’re a diabetic, don’t ignore it. Don’t get to where I am. The sooner you accept things, the better it is for your health.”

Only after her doctor advised amputation did she realize the seriousness of her situation. Schaufer’s lifestyle had a hugely negative impact on controlling her diabetes. 

 

It was very painful!

Schaufer had puss from underneath her foot and necrotic toe. “After the doctor examined my foot, it was like decaying,” she says. “I couldn’t handle the pain. It was excruciating!” She was given less than a year to live because of her poor lifestyle.

 

I started to accept the situation.

Schaufer finally accepted her fate as a diabetic after the doctor told her that her leg would have to be amputated.

“I saw it coming. The pain was terrible. I could no longer handle it. At this point I was prepared; whatever came had to be.”

 

Unexpected turn of events

“I was browsing a support page I found on the web and read about a colleague’s experience with the microcirculation therapy she had tried. She noted that it had an amazing effect on her diabetic foot ulcer,” Schaufer says.

Right there on the support page, the woman raved, “There is this new technology you can buy online, D’OXYVA, which was voted one of the Top 10 Diabetes Care Solution Providers 2018! I didn’t have to amputate my leg because of this amazing product. In just four weeks, I can see my diabetic foot ulcer improving!”

“I read these words, and it gave me the hope I’d been praying for,” noted Schaufer.

She only had a month before her scheduled amputation, and without hesitation, she used the remaining days to try out D’OXYVA. She ordered the product online and closely collaborated with their in-house support.

“I was under D’OXYVA therapy for one month, taking it twice a day, once in the morning and once before bed as advised. It was very easy to use and non-invasive. In the first few days, I was skeptical as I wasn’t seeing any improvements, but I continued anyway and followed their suggested therapy guide,” Schaufer explains.

 

Thankful for D’OXYVA

When it was time for her to go back to her doctor and give her consent to amputate, her doctor was shocked to see her leg.

“What happened?” Those were the exact words my doctor asked upon seeing my leg after only a month. “Your wounds seemed to be healing from the inside,” my doctor said.

After a thorough check-up and the usual diagnostic check of my foot’s PI (perfusion index), he said the words that I never expected to hear. “We don’t need to amputate your leg anymore, but you need to continue whatever you’ve been doing for the past month.”

I then introduced him to D’OXYVA, and he was amazed by how this product had saved me.

 

Helping others

“I’m on my third month of D’OXYVA therapy, and it does amazing things for my health! I don’t think I have thanked D’OXYVA enough for this chance to live longer. I wouldn’t have the outlook on life that I have now,” Schaufer continues cheerfully.    

She is now also leading a healthy life. “This changed how I live my life, and I will continue sharing my experience as much as I can to help others.”

Schaufer often spends time with other “to-be-amputees” struggling to deal with their situation. “God gave me my situation to help others,” she maintains.

One of the ladies she counselled remarked how Schaufer had helped her tremendously. “She told me that I gave her her life back,” Schaufer says, breaking into tears.

“I’m in a way thankful for what I have been through with my diabetes because, without it, I wouldn’t have stumbled across my strength and my ability to help others.”

HOW CAN D’OXYVA 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.

LEARN MORE ABOUT D'OXYVA
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Did you know when used in a regimen, D`OXYVA users have reported a number of health and beauty benefits?

doxyva benefits

OPTIMIZE BLOOD CIRCULATION FOR A WIDE VARIETY OF SIGNIFICANT OUTCOMES

D’OXYVA® (deoxyhemoglobin vasodilator) in various clinical trials has validated leading independent research results and demonstrated above-average results in improving a host of physiological functions at the same time.

People using D’OXYVA® have recorded significant improvements in cardiovascular activity leading to much improved physical activity. As part of a healthy lifestyle, D’OXYVA may help significantly reduce the risk of high blood pressure, hypertension, cholesterol, and diabetes in just two or three months, with an average use of 5 minutes a day and 5 times a week.

Poor circulation is a gateway for a litany of ailments: slow healing, depression, poor complexion, sores, slow metabolism, and more.

D’OXYVA significantly improves sustained oxygen-rich microcirculatory blood flow locally and throughout the body. Its patented method of fully non-invasive, painless, and harmless transdermal delivery is unique only to D’OXYVA.

When used daily, D’OXYVA users have reported a number of health and beauty benefits, including but not limited to:

  • Relief from symptoms of microvascular complications
  • Significantly increased cardiac function, physical fitness, endurance and strength, muscle size, body tone, faster recovery from sports injuries and surgical trauma
  • Improved self-esteem via promoting healthy and radiant skin, complexion, dry skin relief, and acne reduction
  • Significant reduction in downtime from other skin treatments and cosmetic procedures when used in combination, reduction in the appearance of scars, cellulite, fat, spider veins and stretch marks
  • Promoting and maintaining a healthy weight, improving general mobility, deeper, more restful sleep
  • Significant improvement of mental acuity; concentration, problem solving, multitasking, eye-hand coordination, heightened stamina, energy, and focus while managing stress
  • Improved vitals across the board during checkups with zero adverse event reports after years of regular use by people with various health, demographic, and ethnic backgrounds

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.

LEARN MORE ABOUT D'OXYVA
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Anesthesia, Microcirculation, and Wound Repair in Aging

Abstract

Age-related changes in skin contribute to poor wound healing after surgical procedures. Changes in skin with age include a decline in thickness and composition, a decrease in the number of most cell types, and diminished microcirculation, the process that provides tissue perfusion, fluid homeostasis, and delivery of oxygen and other nutrients. It also controls temperature and the inflammatory response. Surgical incisions cause further disruption of the microvasculature of aged skin; however, perioperative management can be modified to minimize damage to aged tissues. Judicious use of fluids, maintenance of normal body temperature, pain control, and increased tissue oxygen tension are examples of adjustable variables that support microcirculation. Anesthetic agents influence microcirculation in a number of ways, including cardiac output, arterial pressure, and local microvascular changes. The authors examined the role of anesthetic management in optimizing microcirculation and potentially improving postoperative wound repair in older persons.

Aged skin is at increased risk of poor postoperative wound healing. Changes in the cutaneous microcirculation with aging contribute to this risk. This review examines the role of anesthesia management in microcirculatory function.

SURGICAL wound repair is a major problem in the older population, who are at increased risk of wound dehiscence and infection. As a specific example, surgical site infections (SSIs) are common (approximately 500,000 cases annually in the United States), lead to worse patient outcome (patients who develop SSI are twice as likely to die), and are an enormous economic burden (1–10 billion dollars annually). Many factors contribute to age-related changes in skin5 and subsequent vulnerability to impaired wound healing and infection. Changes in skin with age (fig. 1) include a decline in epidermal and dermal thickness and composition, as well as a decrease in the number of most resident cell types. The dermal–epidermal junction is flattened and the microcirculation is diminished. The latter is defined as blood flow through arterioles, capillaries, and venules and is the key system that affects the entire skin surface. In the aging patient, the microcirculation in the skin is reduced by 40% between the ages of 20 and 70 yr. The microcirculation provides tissue perfusion, fluid hemostasis, and delivery of oxygen and other nutrients. It also controls temperature and the inflammatory response. Surgical incisions cause disruption of the microcirculation in the skin as manifested by local edema resulting from vasodilation and increased vascular permeability.

Fig. 1.
Numerous changes in skin with age contribute to impaired wound healing.

 

Perioperative management can be modified to optimize the microcirculation. Measures that support the microcirculation include careful use of fluids, normothermia, pain control, and smoking cessation. Factors that can be influenced by intraoperative management (judicious use of fluids, maintenance of normal body temperature, pain control, and increased tissue oxygen tension) have been suggested to be beneficial as well. Most anesthetic agents also influence the microcirculation: a reduction in cardiac output and arterial pressure decreases flow in the microcirculation, whereas anesthetic-induced local microvascular changes and vasodilatation can increase perfusion. Optimization of these variables plays an important role in enhancing the microcirculation in all patients, but is especially relevant if modifications could improve postoperative wound healing in the older population.

In this review, we will use skin as a representative organ to describe age-related changes that negatively affect the microcirculation and have subsequent impacts on wound healing and the incidence of postoperative infection. We will then examine the role of anesthesia management in minimizing detrimental effects on the microcirculation. A greater understanding of these variables could promote improvements that lead to better outcomes with respect to wound repair in older patients.

Summary of Wound Repair and Aging

It has been nearly a century since it was noted that the rate of cutaneous scar formation after a wound is inversely related to the age of the patient. Four decades ago, it was observed that older age was associated with an increased risk of postoperative disruption of the surgical wound, leading to higher mortality. Recent data suggest that in patients older than 65 yr, development of SSI is associated with a two-fold increase in cost and a staggering four-fold increase in mortality.

Wound healing ensues via a sequential chain of events (with variable overlap) that includes inflammation, tissue formation, and remodeling (fig. 2). Circulating factors have a pivotal role in each of these phases. Accordingly, as we will discuss below, immediate changes in the microcirculation influence each stages of the wound-healing response in aging. As human data is lacking, we have taken data from established animal models of aging. Although animal models are not uniformly predictive of responses in human tissues, several animal models of wound healing are generally accepted.

Fig. 2.

The stages of wound healing are a sequential chain of events that include: (A) inflammation, (B) proliferation and granulation tissue formation, and (C) extracellular matrix (ECM) deposition and tissue remodeling. PDGF = platelet-derived growth factor; TGF-β1 = transforming growth factor-β1; TNF-α = tumor necrosis factor-α; VEGF = vascular endothelial growth factor.

 

Summary

Nearly every anesthesiologist who provides care to adults will participate in the care of geriatric patients. A growing older population is undergoing surgical procedures that are increasing in number and complexity. Poor healing of surgical wounds is a major cause of morbidity, mortality, and substantial economic burden. Wound healing is dependent on the microcirculation that supplies the incision area. Measures that support the microcirculation during the perioperative period have a profound effect on wound healing. Some measures such as maintenance of normal body temperature and control of postoperative pain are supported by ample evidence and have been implemented in routine clinical care. Other measures, for example, the choice of anesthesia technique and use of opioids are supported by basic research but need further clinical studies. A better understanding of the effect of aging and anesthesia on the microcirculation can potentially assist in improving postoperative wound repair, thereby benefiting a growing older population.

 

The Surgical Context of Wound Repair and Aging

Measures that support the microcirculation improve wound repair, thereby reducing the risk of postoperative dehiscence and infection.52General preoperative measures such as smoking cessation and optimal management of comorbid medical conditions have been reviewed in other contexts.53,54 For the purpose of this review, we will focus on interventions in the perioperative setting.

Oxygen Administration

Wound healing is dependent upon adequate levels of oxygen.55 Oxygen interacts with growth factor signaling and regulates numerous transduction pathways necessary for cell proliferation and migration.56 It is also an indispensable factor for oxidative killing of microbes.57 Consequently, the effects of oxygen tension on the outcome of surgical wounds have been best studied in the context of postoperative infection. Resistance to surgical wound infection is presumed to be oxygen dependent—with low oxygen tension viewed as a predictor of the development of infection,56 particularly when subcutaneous tissue oxygenation (measured by a polarographic electrode) decreases to less than 40 mmHg.58

In two recent meta-analyses, one found that perioperative supplemental oxygen therapy exerts a significant beneficial effect on the prevention of SSIs,59 whereas the other suggested a benefit only for specific subpopulations.60 Although most authors suggest that supplemental oxygen during surgery is associated with a reduction in infection risk,61,62 others propose it may be associated with an increased incidence of postoperative wound infection.63Notably, in the latter report, the sample size was small and there was a difference in the baseline characteristics of the groups. A prospective trial randomizing patients to either 30 or 80% supplemental oxygen during and 2 h after surgery did not find any difference in several outcome measures including death, pulmonary complications, and wound healing.64 Of note, the administration of oxygen to aged subjects may be limited by the finding that although arterial oxygen tension did not decrease with age, there was reduced steady-state transfer of carbon monoxide in the lungs.65 This indicates that oxygen transport could be diffusion-limited in older subjects, especially when oxygen consumption is increased. Furthermore, longitudinal studies of five healthy men over 3 decades showed impaired efficiency of maximal peripheral oxygen extraction,66 suggesting that tissue oxygen uptake is reduced in the aged subjects.67 This likely reflects a decrease in the number of capillaries as well as a reduction in mitochondrial enzyme activity.68 Animal models (rabbit69 and mouse69,70 ) have suggested that aging and ischemia have an additive effect on disruption of wound healing. Consequently, the potential benefit of increasing tissue oxygen tension during surgical wound repair in older patients should be further evaluated.

 

 

Reference: http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1917910

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Diabetes – Understanding a Debilitating Disease and Its Complications

by Dr. James O.

Honors in Epidemiology, Ophthalmology Electives and Albert Einstein College of Medicine

A Sad Case Struggling with Diabetes – Most people remember the popular movie Animal House and would recognize the popular character Flounder, who was played by the actor Stephen Furst. A recent article in “PeopleCelebrity” (people.com) is useful, for it describes Furst’s lackadaisical attitude toward diabetes, which eventually killed him at the age of 63.

According to the article, both of Furst’s parents died from diabetes-related complications when he was only 16 years old. Several weeks later, Furst himself was diagnosed with diabetes, but he basically ignored his condition, stating: “I went into denial…I didn’t realize the long-term effects.”

Unfortunately, after many years spent battling obesity and diabetes, Furst died on June 16, 2017 from “complications of diabetes.”

What Is Diabetes Mellitus – Diabetes mellitus is a devastating chronic illness that can have horrific and debilitating consequences. This condition, if left untreated, can lead to amputations of multiple limbs, blindness, kidney failure, heart attacks, strokes, hypertension, dental disease, poor wound healing, impotence, loss of sensation in limbs, and many other serious health conditions.

Definition – There are three general types of diabetes. Diabetes mellitus type one, which is also called juvenile diabetes, is usually diagnosed in childhood and accounts for approximately 5% of cases of diabetes. This type of diabetes is usually caused by the body’s inability to produce insulin. Diabetes mellitus type 2 is the most common type of diabetes; it involves an elevation of blood-glucose levels in adults.

This can be due either to the lack of production of the hormone insulin by the pancreas or to the development of a condition called insulin resistance, in which the body’s cells no longer react normally to insulin, thereby preventing insulin from transporting glucose from the blood into the cells. The third type of diabetes is gestational diabetes, which refers to the development of high blood-sugar levels during pregnancy.

Statistics – According to Healthline (healthline.com), 29.1 million people in the United States have been diagnosed with diabetes at a cost of 245 billion dollars per year in health expenses (in 2012), with an estimated 8.1 million more people unaware that they too have the condition. Furthermore, in the United States, approximately 1.4 million new cases of diabetes are diagnosed every year. Worldwide, “[d]iabetes kills 1.5 million people every year” (healthline.com).

Risk Factors – Risk factors for diabetes mellitus include obesity, smoking, (advanced) age, sedentary lifestyle, positive family history, poor diet, elevated cholesterol and triglycerides, and hypertension. Also, African Americans, Native Americans, Asian Americans, Pacific Americans and Hispanic Americans all have an increased risk of developing diabetes.

Warning Signs of Diabetes – Common symptoms of diabetes include severe thirst, frequent urination, dry mouth, intense hunger, blurred vision, poor healing of wounds, dry and itchy skin, and yeast infections.

Complications – One of the major complications of diabetes is damage to what is called the body’s “microcirculation.” This term refers to the circulation of blood in the smallest blood vessels, which are composed of terminal arterioles, capillaries, and venules.

The arterioles (tiny arteries) carry oxygenated blood to the capillaries, where oxygen is then transported to the tissues. The venules (tiny veins) carry deoxygenated blood and C02 from the capillaries to the larger veins.

It is critical for microcirculation to work optimally because its function is critical to the regulation of blood flow, tissue perfusion, normal blood pressure, and normal oxygen delivery and cellular-waste removal.

Studies have shown that early in the course of diabetes, changes begin to occur, namely damaging and thickening the “basement membranes” of microcirculation. This causes alterations in blood-flow properties, alterations in oxygen transport, and changes in homeostasis.

These changes in blood supply, tissue perfusion, and oxygen delivery eventually lead to a progressive loss of nerve-fiber function, causing neuropathy, chronic pain, and numbness.

The damage to microcirculation also causes peripheral vascular disease, which can lead to tissue necrosis, nonhealing ulcers, gangrene, and eventual limb amputation. It is estimated that 2 to 6% of patients with diabetes will develop a diabetic foot ulcer (DFU) that eventually becomes infected. Infected DFUs, in turn, can lead to foot or leg amputation, with 50% of those with amputations dying within 5 years.

Diagnosis – Diabetes can be diagnosed using several common blood tests or urinalysis revealing elevated levels of glucose. A fasting blood sugar over 125 mg/dl (for reference, the normal value is less than 100 mg/dl) may indicate diabetes; a Hgb A1C blood test with a value over 5.7%, which measures average blood-sugar levels over a 3-month period, may also indicate diabetes. Another valuable diagnostic test is the glucose tolerance test used to measure blood-sugar levels 3 hours after oral administration of a sugary syrup.

Traditional Treatments – First-line traditional treatment of diabetes usually involves weight loss, a healthy diet low in carbohydrates and high in fruits and vegetables, and increased exercise for at least 20 minutes 3 times a week.
If diet and exercise are not sufficient to lower blood sugar to normal levels, then medication may be necessary. The first medication usually administered is metformin. Metformin, also known as Glucophage, is an oral medication usually taken twice per day; it works by decreasing the level of sugar produced by the liver and by increasing cells’ sensitivity to insulin. It also lowers the amount of glucose absorbed by the intestines.

Since metformin is metabolized by the liver, if someone has decreased liver function caused by liver disease, this may lead to a buildup of metformin, in turn inducing lactic acidosis, which can cause severe medical conditions and even death.

In the same way, since Metformin is excreted from the body by the kidneys, those with kidney disease and/or lowered kidney function are also at risk of lactic acidosis when taking metformin.

Other types of oral medications are also available to treat diabetes. If these medications fail, daily insulin administration can be given either through injections, inhalation, or an insulin pump.

Traditional treatments of diabetic vascular disease causing impaired circulation include revascularization surgery and angioplasties. Treatment of the tingling, numbness, and sharp pain from diabetic neuropathy include medications such as gabapentin (Neurontin), pregablin (Lyrica), and the antiseizure medicine Tegretol.

Alternative treatments for diabetic neuropathy include Chinese medicine, acupuncture, aromatherapy, massage therapy, reflexology, homeopathy, and biofeedback.

Another treatment that has shown great promise both for the treatment of diabetic neuropathy and diabetic microvascular disease is D’OXYVA. This is a noninvasive, nonopioid transdermal delivery system of medical carbon dioxide (C02) and water vapor that boosts microcirculation, balances the sympathetic and parasympathetic nervous systems, lowers blood pressure, decreases chronic pain, promotes healing of wounds and ulcers, and helps prevent amputations.

D’OXYVA improves blood circulation by means of a transdermal transfer of C02 using a transmission device placed over the thumb for a 5-minute period.
Numerous studies have shown “sustained, remote vasodilation and decreased systolic blood pressure” with the use of D’OXYVA. This is because bathing the tissues in C02 stimulates vasodilation in the periphery of the body, thereby improving circulation, blood flow, and oxygenation levels.

In one particular case, a male patient suffering severe diabetic neuropathy and intractable ulcers and open sores on his legs, along with hypertension and an inability to sleep due to severe pain, was placed on D’OXYVA via his thumb for 5 minutes twice a day for 6 weeks.

By the end of the 6-week period, the patient reported a significant decrease in pain; he reported being able to sleep through the night for the first time in years and reported that most of his leg wounds had healed. In addition, his blood pressure dropped from 188/130 to 135/95 within 30 minutes of each application.

Summary – Diabetes is an insidious chronic condition that devastates both patients and families. Increased awareness and preventive measures, such as controlling diet and increasing regular exercise, can encourage weight loss and hopefully prevent the development or worsening of diabetes and the need for oral medications or treatment with insulin. In addition, new advances in therapy such as D’OXYVA offer a noninvasive, transdermal, low-cost, and very effective alternative to help stop the intractable chronic pain of diabetic neuropathy and to help prevent limb amputations.

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Breaking News from the PWCS Regional Conference

Following Successful Wound Healing Pilot Study, Circularity Launches Multicenter Clinical Trials, Business Initiatives with Influential Experts Across the Region

The Philippine Wound Care Society is a non profit, non stock, SEC registered organization. It was founded on September 09, 2009 with the purpose of improving the wound management in the Philippines through education. The society which is composed of physicians from different specialty groups and allied services (wound care nurse, physical therapy) brings together professionals involved in wound care.
 
The organization held its 1st regional meeting last February 26-27, 2015 at Cebu City Philippines. InvisiDerm’s CEO, Norbert Kiss and Senior Sales and Marketing Manager, Jennifer Rose Boadilla were invited by the President of the organization, Dr. Martin Anthony A. Villa and got the chance to meet some of the most influential cardiovascular and wound care KOLs at the said event.
 
The event was professional and had overwhelming participation exceeding the initially registered numbers. The speakers and their presentations were high quality and informative showcasing the latest in technologies and approaches to wound management.
 
We are glad to announce that InvisiDerm has secured some of the most influential cardiovascular and wound care KOLs from Taiwan, Singapore, Japan, Korea, Philippines and a few other countries via strategic relationships at this Philippine Wound Care Society Regional Meeting. In addition, a protocol for a comprehensive multicenter study coupled with diagnostics for diabetic foot wound healing on hundreds of subjects at leading hospitals, and an academic level study into the biochemical properties of D’OXYVA in wound healing, and a study for erectile dysfunction in diabetics was finalized, agreed and initiated with several KOLs based on the successful pilot study conducted by Dr. Harikrishna R. Nair at Hospital Kuala Lumpur, Malaysia. The quality of life benefits for patients such as significantly improved sleeping, eating, mood and pain makes D’OXYVA a distinct winner besides being noninvasive and fast without negative side effects. Furthermore, InvisiDerm has met regional directors of several leading wound care products multinationals and their distributors for in-depth private discussions about business models and development challenges across Asia. Circularity is clearly a leader in a number of aspects if not most. Special thanks to the team at Getz Bros. Philippines for their warm hospitality.
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D’OXYVA as endorsed by Dr. Stephen Pfeifer

I was introduced several years ago to the transdermal CO2 D’OXYVA® delivery system and had the chance to utilize this modality in my practice as well as see the benefits noted by other clinicians who have started implementing the protocols. I was initially skeptical that such an affordable and simple system could have such profound health benefits. But after witnessing improvements in blood pressure, chronic venous insufficiency, diabetic wound healing, mood, and athletic performance enhancement, I realized that this treatment has the potential to help millions of patients with chronic health conditions. So, like most scientists, I began to investigate the reasons why this technology could be so effective.

Could it be possible that one of the main causes of most of our patients’ health problems is rooted in physiologic imbalances in the autonomic nervous system and microcirculation? Have we clinicians been chasing imperfect treatment options with medications and interventions that may certainly ameliorate symptoms initially, but which fail to address critical root causes of physiologic dysfunction and dysregulation?

There is an increasing consensus that microcirculation is critical in many ways. Our vascular system works in such a way that the great arteries have little impact on blood pressure, but small ones control almost 70% of the blood-flow resistance. Each adult organ can have more that 2 miles of capillaries inside it. Each capillary bed is in charge of exchanging small molecules between organ cells and the blood to maintain a healthy cell microenvironment or a state of homeostasis. The vascular system reacts to the concentration of metabolism’s by-products by deciding where to allocate resources and remove waste. However, with time and the accumulation of microcirculation damage due to bad health care habits, poor diet, and sickness, our bodies lose their ability to maintain homeostasis, resulting in poor wound healing, pain, infections, and so on. In other words, the microcirculation system helps our bodies maintain uninterrupted blood flow where it is needed the most.

Another overlooked system is the autonomic nervous system. Many books have been written in the functional medicine arena regarding the concept of adrenal exhaustion, as holistic doctors are realizing that this fundamental imbalance contributes to so many health conditions today. Today, we are bombarded with bad news on TV, we have work and financial challenges, and we have constant interruptions from our cell phones and emails. This constant attack on our survival cortisol hormones can be overwhelming. In functional medicine, we can even document this phenomenon with salivary cortisol hormone levels measured 4­–6 times per day. Typically, we see three progressive levels at play. The adrenal system starts as stressed and wired, then progresses to stressed and tired, followed by burned out and exhausted. At each level, this autonomic imbalance takes its toll on our health. Mother nature provided us with a wonderful adaptive capability to mount a stress response when, in the caveman days, we were running from a pack of wolves. It diverts all energy away from the parasympathetic system (rest and digestion) to a sympathetic response (fright and flight) so we can respond physically, using muscle strength, increased heart rate, and increased cardiac output to respond to a physical challenge. After the challenge is gone, the body should return to homeostasis and a calming parasympathetic mode for rest and digestion. Well, that is just not happening in today’s world, as we are in constant overdrive trying to escape the pack of wolves. So, we primary care doctors are always recommending stress-reduction strategies like yoga, better sleep hygiene, blood sugar stabilization diet strategies, and vitamin supplements that support adrenal balance.

It is refreshing to see a new technologic advancement that can help the many health problems exacerbated by autonomic imbalances. A simple and safe 5-minute transdermal CO2 delivery device has been shown to work immediately, and there is scientific proof that the physiologic effects continue for many hours. Scientific evidence is available that transdermal CO2 delivered by the D’OXYVA® device works through several mechanisms:

Reduces inflammation by reducing free radical plasma levels

Raises antioxidant levels and induces vasodilation (microcirculation) through humoral pathway communication

Decreased R-R heart rate interval variation

Activation of the PNS parasympathetic system, causing a vasodilation response

D’OXYVA® is a class 1 low-risk medical device using the natural properties of CO2 (a FDA-cleared drug) to activate our body’s chemoreceptors and increase organ blood flow through microcirculation while promoting oxygen delivery in capillary beds and organ tissue.

My name is Dr. Steve Pfeifer, and I am a consultant for Circularity and a retired functional medicine doctor. I am proud to be part of the Circularity scientific team that is partnering with clinicians to continue independent research regarding these benefits. More than two dozen research projects have been performed to test D’OXYVA® ‘s potential and safety, and much more are ongoing throughout the world. In fact, at the D’OXYVA® University here in Indianapolis, our doctors are studying the athletic enhancement potential in elite Indy Car race drivers and general athletes to document objective benefits with recovery and pulse oximeter readings reflecting perfusion indexes.

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Peripheral Edema and D’OXYVA Transdermal Application as a Potential Treatment Option

Peripheral edema is the result/manifestation of many diseases, inflammation processes, and loss of body compensatory mechanism of chronic conditions, but the first pathophysiology disturbance is at the capillary level (microcirculation). D’OXYVA® transdermal CO2 application has demonstrated to be beneficial to improve blood flow by decreasing microcirculation blood resistance and improving venous insufficiency. CO2 is one of the few local humoral mediators with the potential to modulate blood flow in capillary beds. CO2 enhances the following capillary bed functions:

– Arteriole elastic retractions and vasomotion that allows constant blood flow through the capillary bed.

– Reconstruct the role of adjacent closed capillaries.

– Promote vasodilation of the arterio-venous anastomosis without increased venous return.

Also, CO2 is a natural anti-inflammatory agent that helps one’s circulatory system to perform better. CO2  especially helps one’s circulatory system by increasing venous blood return to the heart and systolic output by passive peripheral vasodilation, without increasing mean arterial blood pressure.
It is important that any patient who has edema needs to be followed/supervised by a physician because there is the need to assess critical organ functions and etiology of the disease, like BP, venous obstruction, low plasma protein concentration, or lymphatic obstruction among others.

 

 

References:
Cellulite and carbon dioxide bath. (2009, May 9).

Dogaru gabriela, r. A. (2015). Therapeutic effects of carbonated mineral waters in cardiovascular rehabilitation . Balneo research journal, 36-39.

Maria vitória carmo penhaveli, v. H. (2013). Effects of carbon dioxide therapy on the healing of acute skin wounds induced on the back of rats1. Acta cirúrgica brasileira , 334-339.

Nouvong, j. S. (n.d.). Assessment of microcirculation and the prediction of healing in diabetic foot ulcers. Western University of Health Sciences, College of Podiatric Medicine United States of America:

www.intechopen.com.

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How does Poor Blood Circulation Affect your Skin?

We all know how a poor blood circulation can affect our state of health but do you also know that a poor blood circulation can adversely affect our state of skin too? Well, I sort of know but I didn’t really think too much of it until I was introduced to donkey skin gelatin for beauty as I learnt from my bestie that not only did her relative’s skin tone improved after taking the herbal mixture, but her pigmentation spots actually faded because the herbal mixture promote blood circulation and increase the reproduction of cells. Now, that got me thinking that perhaps some of my skin problems might be due to a poorer blood circulation.

What skin problems can a poor blood circulation cause?
I’m not going to cite any medical studies here but if you think about it, a better blood circulation will definitely increase the reproduction of cells, and this will benefit the skin too. So while a poor skin condition could be due to many reasons, a poor blood circulation is definitely going to show up as poor skin condition. Here, I’ll cover briefly on six skin problems that can result due to poor blood circulation.

 

1. Unflattering skin tone

When someone is anemic and has a poor blood circulation, chances are, that person has a pallid complexion. In some cases, the skin tone is also dull and may even look ashy.

 

2. Skin discoloration

Poor blood circulation often results in a lack of oxygen in the blood and hence, this can also cause skin pigmentation, dark spots or blotchy complexion.

 

3. Acne and problematic skin

Obviously, a poor blood circulation is going to affect how some of your major organs function and over time, these organs can become stressed and are unable to eliminate toxins properly. This can put more pressure on your lymphatic system and your lymph nodes can become sluggish with toxins building up and then excreted through the skin, causing acne or other problematic conditions such as dry skin, itchy skin or even skin rashes.

 

4. Slower scar healing

Those with acne and have poor blood circulation may find that their acne wounds take a longer time to heal because there is less efficient transport of good nutrients into the skin cells.

 

5. Wrinkle formation

As mentioned, if your blood cannot circulation well, there is less efficient transport of good nutrients into the skin cells, and this can adversely affect collagen production – thereby causing wrinkle formation.

 

6. Dark eye circle

While not all dark eye circles are a result of poor blood circulation but because the skin in the area around our eyes is quite thin, poor circulation results in less oxygenated blood, manifesting in a bluish/purplish appearance under the eyes called dark eye circles.

 

How to improve your blood circulation

Actually, I noticed that my skin has improved gradually over these few months. Yes, the products I’ve used would have helped but one of the improvements I noticed was that my undereye area is no longer so dark. I don’t need to use thick concealer and can make do with normal foundation. At first, I thought the eye cream I am using has helped but I doubted because external products don’t help my undereye area very much except for reducing the fine lines. Then I remembered that I’ve been taking Fit Solution for over six months now and that health supplement has definitely been improving my blood circulation. In addition, I noticed that my acne healing is much faster these days too.

 

1. Diet and health supplements

A balanced diet rich in vitamin B, C, D and E will be helpful. However, if you find that you are not getting sufficient sources from your food, try taking a vitamin supplement if that is a comfortable idea to you.

 

2. Exercise

I don’t exercise but it is a sure way to increase blood circulation. In fact, as soon as you start exercising, you’ll notice that your complexion might start looking rosier because of the increased blood circulation that shows up on the surface.

 

3. Massage

Due to the physical manipulation of soft tissue and also the chemicals released in our bodies as part of the relaxation response, massage increases the circulation of blood. Such an improved circulation can enhance the delivery of oxygen and nutrients to skin cells. So both body and facial massages are good to indulge in for a better blood flow.

I think someone who is healthy is likely going to have a better blood circulation than one who is not. So if you suspect that your blood circulation is causing your skin problems, perhaps it’s time to improve your diet or take time to exercise for the blood flow to circulate better.

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D’OXYVA AND ITS POSITIVE IMPACT ON PATIENTS’ HEALTH

What is D’OXYVA?

The D’OXYVA®  device is a simple, commercially- available device to deliver transdermal carbon dioxide (CO2). It consists of a patented and patent-pending ergonomic polymer shell that is propelled by a patented single-use mini steel pressurized cartridge (45 psi) filled with pharmaceutical-grade (99.5%) liquid, purified CO2. The mini-steel cylinder is GMP-compliant, and recyclable.

D’OXYVA was identified by the IRB in a human clinical trial as a non-significant risk (NSR) device.

The D’OXYVA device is manufactured in the United States and other countries. D’OXYVA is an ISO-complaint device, which means that Circularity Healthcare, LLC has received a certification to certify that D’OXYVA fulfills all of the international requirements for medical device regulations, like risk assessment and maintaining effective processes for safe design, manufacture and distribution.manufacture and distribution.

 

WHO IS INVOLVED IN IMPROVING HEALTHCARE FOR PATIENTS?

CO2 is the protagonist in D’OXYVA’s revolutionary approach to improving healthcare and patients’ quality of life. The medical device causes controlled ischemia-like stress in a local area of the body to promote central nervous system activity and circulate humoral agents that favor micro-circulation, especially at the organ capillary beds.

Adequate blood flow in the capillary bed is essential for tissue survival and optimal organ function. If blood passes too fast or does not pass at all, the tissue cannot extract O2 efficiently and will generate what is known as capillary dysfunction, which is related to chronic pain, poor wound healing, diabetic neuropathy and Alzheimer’s disease, among other conditions.

 

WHAT DO WE USUALLY REMEMBER ABOUT CO2?

· It is a key player in regulating extracellular hydrogen concentrations and pH through various systems, like the respiratory system, kidneys and various buffers.

· Biochemistry: An increase or decrease in 1 mmHg pCO2 will cause a decrease or increase in pH of 0.08 units in acute patients. In chronic patients, a pCO2 change of 1 mmHg will cause a pH change of 0.03 units.

· The Bohr and Haldane effects determine the interaction of O2 and CO2. At the cellular level, pCO2 concentration causes Hb-O2 dissociation.
· It is attained by our body through inhalation.

 

WHAT DO WE USUALLY FORGET ABOUT PCO2?

· Increased pCO2 promotes arteriolar dilatation in various tissues, while a modest effect has been shown in skeletal muscle tissues.

· CO2 can be delivered into our body through the skin (transdermal).

It is used in the medical industry to:

· Rapidly increase the depth of anesthesia when volatile agents are being administered—it increases the depth of respiration and helps to overcome breath holding and bronchial spasm

· Facilitate blind intubation in anesthetic practice

· Facilitate vasodilation and thus lessen the degree of metabolic acidosis during the induction of hypothermia

· Increase cerebral blood flow in arteriosclerotic patients undergoing surgery

· Stimulate respiration after a period of apnea

· Prevent hypocapnia during hyperventilation

 

It is also used in:

· Clinical and physiological investigations

· Gynecological investigations for insufflation into the fallopian tubes and abdominal cavities

· Tissue-freezing techniques (as dry ice) and to destroy warts by freezing.

· The CO2 concentration increment potentiates the S-shaped hemoglobin (Hb) to O2 dissociation curve. It helps Hb to unload O2 from 40% O2 dissociation under normal conditions to 70% O2 dissociation under increase CO2 concentration.

 

WHERE DOES CO2 VAPOR DELIVERED THROUGH THE SKIN TAKE ACTION IN THE BODY?

Transdermal delivery of CO2 has proved to improve local microcirculation (capillary beds) blood flow and tissue perfusion, but it also positively improves systemic blood pressure and TcpO2 (most likely due to the Bohr effect). As mentioned before, therapeutic medical-grade CO2 is used for vasodilatation in the medical field for several conditions and procedures.

Local, CO2 therapy has shown great success rates to improve the healthcare of patients through:

· Treatment for diabetic foot

· Increased microcirculation blood flow and dissociated O2 in healthy and diabetic individuals

·Treatment for arterial stenosis obliterans

· Chronic wound healing

· Adipose tissue treatment

 

Systemically, CO2 therapy has shown great success to improve:

· The healthcare of patients with high blood pressure

· General vital organ function, like that of the: – Pancreas – Liver – Brain – Kidneys

We are currently finding clinical researchers who are interested in participating in clinical trials with our medical device. Our goal is to produce scientific evidence of D’OXYVA’s potential to improve healthcare.

 

OUTSTANDING CLINICAL RESEARCH RESULTS

More than two dozen research projects have been performed to test D’OXYVA potential and its capability to help patients obtain wellness. We have tested the efficiency, tolerability and safety of the D’OXYVA medical device in delivering a gentle, highly concentrated CO2 mist to the body through the skin and prove the reproducibility of its effects beyond doubt. To do so, we measured body CO2 concentration before and after treatment as well as the expected physiological response to CO2 treatment. In addition, we have partnered with healthcare leaders and clinicians to perform independent research studies.

Research end points:

1) Safety and tolerability  Up to date, no adverse side effects or negative healthcare responses have been recorded from our clients using D’OXYVA. Also, no participants in our research projects had any documented side effects from treatment. We encourage you to discuss with your healthcare professional if D’OXYVA medical device is right for you.

· Up to date, no adverse side effects or negative healthcare responses have been recorded from our clients using D’OXYVA. Also, no participants in our research projects had any documented side effects from treatment. We encourage you to discuss with your healthcare professional if D’OXYVA medical device is right for you.

· Measured transcutaneous carbon dioxide (TcPCO2)

· Within the first 5 minutes of D’OXYVA treatment, TcPCO2 increases in the body, followed by a decline slope that lasts approximately 240 minutes until returning to baseline values.

· In healthy individuals, D’OXYVA does not increase pCO2 beyond the body buffer’s manageable range, making it completely safe.

 

2) Efficiency CO2 delivery

a. Measured blood perfusion index (PI)
· The results of each research project consistently showed a significant increment on PI in 100% of participants within the first 5 minutes of treatment, peaking at 60 minutes after treatment. From 60 minutes after treatment until 240 minutes (our largest time period evaluated after treatment), PI decreased slowly to baseline levels. PI studies on diabetic patients has demonstrated a greater response to CO2 that in non-diabetic healthy individuals. Our studies have recorded that the PI change (from baseline) in diabetic patients was double the PI change recorded in healthy patients (Graph 1).
Graph 1: Skin perfusion index (SPP) in healthy and diabetic participants vs. time after using the D’OXYVA medical device

b. O2 concentration
 D’OXYVA has consistently reported increased free O2 molecules in our patients’ blood streams. The effective transdermal CO2 delivery allows the body to increment O2 availability through the Bohr effect, which helps hemoglobin cells to unload O2 more easily by decreasing its affinity.

c. Blood pressure
All of the research projects performed up to date have consistently recorded a significant decrease in systolic blood pressure (from the heart) and diastolic (return to the heart) blood pressure. These results have been consistent throughout all study time periods up to 240 minutes (our longest time period evaluated after treatment).

d. Diabetic ulcer
A research project focusing on D’OXYVA’s impact on diabetic ulcers recorded significant changes in wound healing, like significant granulation of tissue and improved ulcer borders, as soon as 1 week into the D’OXYVA treatment plan (Image 1).

e. Sports
Amateur and professional athletes are always searching for ways to improve cardiovascular function and increase the vascular transport capacity of skeletal muscle. Better vascular transport capacity translates to more O2 and nutrients delivered to our muscles, which means better performance in the field.
D’OXYVA research focusing on the perfusion index (PI) of superficial skeletal muscles has recorded excellent results. The most important findings demonstrate that participants who use D’OXYVA doubled their PI in comparison to the control group.

f. Blood alkalinity
Use of D’OXYVA has consistently been shown to improve local cellular homeostasis. It has the potential to improve body pH values by promoting an alkaline ambiance. A slightly alkaline microenvironment After 7 days of treatment with D’OXYVA (1x per day) – same wound dressing as before within the body promotes good health and optimal body organ performance.

 

WHEN WILL PATIENTS BEGIN TO PERCEIVE HEALTHCARE BENEFITS AFTER STARTING D’OXYVA?

The SENTEC digital monitor system has confirmed successful and constant CO2 transdermal delivery to the skin capillary bed after a 5-minute period of exposure to highly concentrated CO2 vapor produced by D’OXYVA.
The perceived healthcare benefits occur almost instantly, with local microcirculation improvements followed by an increment of SPO2 that last up to 240 minutes.

Nonetheless, adherence to a D’OXYVA regiment has demonstrated benefits to individuals suffering from difficult-to-heal skin wounds like diabetic ulcers, who demonstrated significant clinical improvements after two weeks of D’OXYVA.
Patients who achieved D’OXYVA device adherence for more than a month have shown wellness that persists in clinical trials.

Why can the D’OXYVA medical device and its capacity to produce highly concentrated CO2 vapor improve general health care? Judy M. Delp, Ph.D. in physiology and professor at the Florida State University, described D’OXYVA as a simple commercially available device used to deliver transdermal CO2 that has shown remote vasodilation, which may be mediated through the release of a circulating humoral agent.**

CO2 improves general healthcare in several ways:

· It has natural anti-inflammatory characteristics.

· It increases blood flow through microcirculation, by arteriolar/venous dilatation.

· It produces a rightward shift in the O2 dissociation curve.

· It enhances oxygen delivery at the cellular level in the muscles, organs, brain, skin and other parts of the body.

· It is a fat-dissolving compound.

· It naturally sedates and calms the central nervous system.

· It can be used to reconstruct functionally closed capillaries.

· It can improve venous response.

· It improves blood-flow properties.  It can be used to sedate the central nervous system.

 

IS D’OXYVA SAFE FOR MY PATIENTS (HUMANS AND PETS)?

Circularity Healthcare operates a state-of-the-art supply chain and quality management system (QMS) for manufacturing. Circularity has certificates of registration for IS EN ISO13485:2012 (European Union) and ISO13485:2003 under CMDCAS (Canada), which it has been implementing since 2013.

D’OXYVA is a CE-marked medical device (Class I, low risk) for delivery of medications via the skin. Circularity is seeking approval from the U.S. FDA and other countries for delivery of medical gases such as medical carbon dioxide (USP UN1013) via a novel, patented, non-invasive transdermal route with D’OXYVA to treat various widespread conditions.

Medical carbon dioxide is manufactured and delivered under applicable standards per each country’s regulatory requirements. In the United States, the Food and Drug Administration has cleared the use of medical carbon dioxide through inhalation for humans but not yet through transdermal delivery with D’OXYVA. Transportation of medical carbon dioxide via any postal or courier service requires a certification for handling dangerous goods (HAZMAT) by the U.S. Department of Transportation (DOT).

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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.