Search Results (10)

Study Design: Retrospective cohort study. Objective: Frontal sinus fractures (FSFs) can lead to a range of clinical challenges, including facial deformity, impaired facial sensation, cerebrospinal fluid (CSF) leakage, sinus drainage impairment, chronic sinus pain and mucocele formation. The optimal management approach, whether surgical or conservative, remains a topic of ongoing discussion. The aim of this study was to evaluate and compare the functional and esthetic outcomes of patients with surgically and conservatively treated FSFs. Methods: In this retrospective study, patients treated for FSFs at the Karolinska university hospital 2004 to 2020 were identified in hospital records and invited to participate in a long-term follow-up. Sequelae and satisfaction with the esthetic result were assessed trough questionnaires and physical examinations. Results: A total of 93 patients were included in the study, with 49 presenting isolated anterior wall fractures and 44 presenting combined anterior and posterior wall fractures. Surgical intervention was performed in 45 cases, while 48 were managed conservatively. Among patients with moderate anterior wall fractures (4–6 mm dislocation), 80% of surgically treated patients compared to 100% of conservatively treated patients expressed satisfactionwith their cosmetic outcomes at follow-up (p = 0.03). In conservatively treated patients with a forehead impression, the anterior wall fracture dislocation ranged from 5.3 to 6.0 mm (p < 0.0001). Approximately 50% of surgically treated patients vs 15% of conservatively treated patients developed impaired forehead sensation at follow-up (p = 0.03). Thirty-six percent of surgically treated patients reported dissatisfaction with surgery-related scarring, particularly those who underwent surgery via laceration or bicoronal incision. Conclusions: This study suggests that anterior FSFs with a dislocation of 5 mm or less can be effectively managed conservatively with high patient satisfaction, low risk of long-term forehead sensation impairment and without potential development of forehead impression. Bicoronal incision or incision via a laceration may be associated with esthetic dissatisfaction and late sequelae such as alopecia. Full article

Various jobs, indoors and outdoors, are subjected to severe cold temperatures during daily activities. Extremely low-temperature exposure and work intensity affect health, safety, and occupational performance. This work aimed to assess the physiological and thermal sensation responses before, during, and following a 60 min exposure to cold (−20 °C), during which occupational activities were developed. Using ingestible telemetric temperature pills, eight skin temperature sensors, blood pressure equipment, and the Thermal Sensation Questionnaire, experiments were conducted with 11 healthy male volunteers wearing highly insulating cold protective clothing. The most notorious alterations were reported in mean skin temperatures and thermal sensation responses during the first 20 min of cold exposure. Among the eight skin temperature points, the forehead and left hand showed a higher sensitivity to cold. The mean core temperature reported significant variations throughout the protocol, with decreases during the initial 10 min of cold exposure and posterior increases despite the cold environment. Blood pressure showed slight increases from the initial to the recovery period. Overall, outcomes contribute to current scientific knowledge on physiological and perception responses in extremely cold environments while describing the influence of protective clothing and occupational activities on these responses. Future research should be developed with additional skin temperature measurements in the extremities (fingers, face, and toes) and the analysis of thermal sensation potential associations with performance changes, which can also be of great significance for future thermal comfort models. Full article

Background and Objectives: Acne scars are one of the most disturbing and long-term symptoms of acne vulgaris, having a negative impact on a person’s physical, emotional, and social well-being. Aim: the purpose of the study was to evaluate the efficacy and post-treatment outcomes of a dual-wavelength system combining the irradiation of two wavelengths at 10,600 nm and 1540 nm in the management of facial atrophic acne scars. Materials and Methods: Four healthy adult volunteers aged 24–53 years were enrolled. The areas treated were the full face (two patients), cheeks (one patient), and forehead (one patient). A dual-wavelength system (1540 nm and 10,600 nm) was used for this study. Patients underwent 2–4 treatment sessions, and the treatments were performed once every 45–90 days. All possible side effects such as burning sensation, dyschromia, mild to moderate post-treatment erythema, bleeding, itching, edema, and crusting were checked. The index to assess edema and erythema was based on a four-point scale (none, mild, moderate, and severe) and was applied before and at 3-month follow-up (3 MFU) after the last treatment session. In addition, a patient assessment was conducted before treatment and at 3 MFU after the last treatment session. Results: For all patients examined, the edema index was mild, while for the erythema index, 3/4 patients experienced moderate and 1/4 patients experienced mild symptoms. The mean patient downtime was 5.8 ± 0.5 days. Concerning the patient assessment, 2/4 subjects showed excellent improvement, 1/4 patients showed good improvement, and 1/4 patients showed slight improvement. As shown by the photographic assessment, a noticeable improvement in skin texture and a substantial reduction in acne scars were observed at the end of treatment. Conclusions: This dual-wavelength laser technology has the potential to be an interesting and safe approach for acne scar treatment, with a low risk of scarring/hypopigmentation and a shorter healing time. Full article

Chronic pain impacts one in five Americans and is difficult to manage, costing ~USD 600 billion annually. The subjective experience of pain is a complex processing of central nervous system input. Recent advances in magnetic resonance imaging revealed the prefrontal cortex as vital to the perception of pain and that changes in the cerebral hemodynamics can be used to detect painful sensations. Current pain monitoring is dependent on the subjective rating provided by patients and is limited to a single time point. We have developed a biomarker for the objective, real-time and continuous chronic pain assessment using proprietary algorithms termed ROPA and cerebral optical spectrometry. Using a forehead sensor, the cerebral optical spectrometry data were collected in two clinical sites from 41 patients (19 and 22, respectively, from sites 1 and 2), who elected to receive an epidural steroid injection for the treatment of chronic pain. Patients rated their pain on a numeric rating scale, ranging from 0–10, which were used to validate the ROPA objective pain scoring. Multiple time points, including pre- and post-procedure were recorded. The steroid injection was performed per standard medical practice. There was a significant correlation between the patient’s reported numeric rating scale and ROPA, for both clinical sites (Overall ~0.81). Holding the subjective pain ratings on a numeric rating scale as ground truth, we determined that the area under the receiver operator curves for both sites revealed at least good (AUC: 64%) to excellent (AUC > 98%) distinctions between clinically meaningful pain severity differentiations (no/mild/moderate/severe). The objective measure of chronic pain (ROPA) determined using cerebral optical spectrometry significantly correlated with the subjective pain scores reported by the subjects. This technology may provide a useful method of detection for the objective and continuous monitoring and treatment of patients with chronic pain, particularly in clinical circumstances where direct assessment is not available, or to complement the patient-reported pain scores. Full article

Assistive technology uses multi-modal feedback devices, focusing on the visual, auditory, and haptic modalities. Tactile devices provide additional information via touch sense. Perception accuracy of vibrations depends on the spectral and temporal attributes of the signal, as well as on the body parts they are attached to. The widespread use of AR/VR devices, wearables, and gaming interfaces requires information about the usability of feedback devices. This paper presents results of an experiment using an 8-channel tactile feedback system with vibrators placed on the wrists, arms, ankles, and forehead. Different vibration patterns were designed and presented using sinusoidal frequency bursts on 2, 4, and 8 channels. In total, 27 subjects reported their sensation formally and informally on questionnaires. Results indicate that 2 and 4 channels could be used simultaneously with high accuracy, and the transducers’ optimal placement (best sensitivity) is on the wrists, followed by the ankles. Arm and head positions were inferior and generally inadequate for signal presentation. For optimal performance, signal length should exceed 500 ms. Furthermore, the amplitude level and temporal pattern of the presented signals have to be used for carrying information rather than the frequency of the vibration. Full article

Tactile hallucinations frequently occur after mental illnesses and neurodegenerative diseases like Alzheimer’s and Parkinson’s disease. Despite their common occurrence, there are several complicating factors that make it difficult to elucidate the tactile hallucinations. The forehead tactile hallucination, evoked by the physical object approaching to the forehead, can be easily and consistently evoked in healthy-bodied subjects, and therefore it would help with investigating the mechanism of tactile hallucinations. In this pilot study, we investigated the principles of the forehead tactile hallucination with eight healthy subjects. We designed the experimental setup to test the effect of sharpness and speed of objects approaching towards the forehead on the forehead tactile hallucination, in both a physical and virtual experimental setting. The forehead tactile hallucination was successfully evoked by virtual object as well as physical object, approaching the forehead. The forehead tactile hallucination was increased by the increase of sharpness and speed of the approaching object. The forehead tactile hallucination also increased the tactile sensitivity on the forehead. The forehead tactile hallucination can be solely evoked by visual feedback and augmented by the increased perceived risk. The forehead tactile hallucination also increases tactile sensitivity. These experimental results may enhance the understanding of the foundational mechanisms of tactile hallucinations. Full article

Face and neck cooling has been found effective in improving thermal comfort during exercise in the heat despite the fact that the surface area of human face and neck regions accounts for only 5.5% of the entire body. Presently very little documented research has been conducted to investigate cooling the face and neck only to improve indoor thermal comfort. In this study, two highly energy efficient wearable face and neck cooling fans were used to improve occupant thermal comfort in two warm indoor conditions (30 and 32 °C). Local skin temperatures and perceptual responses while using the two wearable cooling fans were examined and compared. Results showed that both cooling fans could significantly reduce local skin temperatures at the forehead, face and neck regions by up to 2.1 °C. Local thermal sensation votes at the face and neck were decreased by 0.82–1.21 scale unit at the two studied temperatures. Overall TSVs decreased by 1.03–1.14 and 1.34–1.66 scale units at 30 and 32 °C temperatures, respectively. Both cooling fans could raise the acceptable HVAC temperature setpoint to 32.0 °C, resulting in a 45.7% energy saving over the baseline HVAC setpoint of 24.5 °C. Furthermore, occupants are advised to use the free-control cooling mode when using those two types of wearable cooling fans to improve thermal comfort. Finally, despite some issues on dry eyes and dry lips associated with those wearable cooling fans, it is concluded that those two highly energy-efficient wearable cooling fans could greatly improve thermal comfort and save HVAC energy. Full article

Background: Urothelial carcinoma ranks as the fourth most common cancer in men in the U.S; upon diagnosis, 10–15% have metastasized, mostly to lymph nodes, liver, lung, bone, and adrenal glands. Very few cases of skull invasion have been reported, and there is no established definite treatment. Case presentation: A 64-year-old Taiwanese male presented with metastatic urothelial carcinoma (mUC) of bladder with skull invasion. A sunken forehead without painful sensation could be palpated. After failure of chemotherapy, the patient received immunotherapy pembrolizumab, and complete remission of distant metastasis with reossification of osteolytic skull were noted. Conclusion: Immunotherapy has been reported to show significant remission in mUC, but mostly in solid organs or bone. While skull metastasis usually suggests late progression of the disease, immunotherapy has fewer systemic adverse effects than chemotherapy, and should be taken into consideration as a first-line therapy. Full article

Thermally comfortable indoor environments are of great importance, as modern lifestyles often require people to spend more than 20 h per day indoors. Since most of the thermal comfort models use a variety of different environmental and personal factors that need to be measured or estimated, real-time and continuous assessment of thermal comfort is often not practically feasible. This work presents a cheap and non-invasive approach based on infrared imaging for monitoring the occupants’ thermal sensation and comfort in real time. Thanks to a mechatronic device developed by the authors, the imaging is performed on the forehead skin, selected because it is always exposed to the environment and, thus, facilitating the monitoring activity in a non-invasive manner. Tests have been performed in controlled conditions on ten subjects to assess the hypothesis that the forehead temperature is correlated with subjects’ thermal sensation. This allows the exploitation of this quantity as a base for a simple monitoring of thermal comfort, which could later be tuned with an extensive experimental campaign. Full article

Many people feel frequent prickling or itching sensations on their scalp. The scalp is an atypical area of the skin since it is normally covered with thick hair and has many sebaceous glands and sweat glands. The scalp often has skin problems that can affect its sensitivity and functions. However, not much is known about stratum corneum function and the neural sensitivity of the scalp. Here we evaluated stratum corneum function and the neural sensitivity of the scalp of 47 normal male individuals in various skin conditions and compared the results to that to the forehead. The neural sensitivity was evaluated by measuring the electrical current perception threshold (CPT). The cutaneous barrier function and stratum corneum moisture-retention ability (MRA) of the scalp were significantly lower than on the forehead, even if there were some scalp problems. Depending on the increase in severity of scalp skin problems, both these skin functional properties and the CPT decreased significantly. However, regardless of its lower functional properties, scalp skin was not significantly lower than that of the forehead. Although the scalp has a low stratum corneum function compared with the forehead and has easily induced skin problems, the scalp skin has less sensitive sensory nerves, resulting in experiencing a worsening of scalp symptoms more easily. Full article