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Critical Care Explorations Feb 2024Near-infrared spectroscopy (NIRS) is used in critical care settings to measure regional cerebral tissue oxygenation (rSo). However, the accuracy of such measurements has... (Review)
Review
OBJECTIVES
Near-infrared spectroscopy (NIRS) is used in critical care settings to measure regional cerebral tissue oxygenation (rSo). However, the accuracy of such measurements has been questioned in darker-skinned individuals due to the confounding effects of light absorption by melanin. In this systematic review, we aim to synthesize the available evidence on the effect of skin pigmentation on rSo readings.
DATA SOURCES
We systematically searched MEDLINE, Cochrane Database of Systematic Reviews, Embase, and Google Scholar from inception to July 1, 2023.
STUDY SELECTION
In compliance with our PROSPERO registration (CRD42022347548), we selected articles comparing rSo measurements in adults either between racial groups or at different levels of skin pigmentation. Two independent reviewers conducted full-text reviews of all potentially relevant articles.
DATA EXTRACTION
We extracted data on self-reported race or level of skin pigmentation and mean rSo values.
DATA SYNTHESIS
Of the 11,495 unique records screened, two studies ( = 7,549) met our inclusion criteria for systematic review. Sun et al (2015) yielded significantly lower rSo values for African Americans compared with Caucasians, whereas Stannard et al (2021) found little difference between self-reported racial groups. This discrepancy is likely because Stannard et al (2021) used a NIRS platform which specifically purports to control for the effects of melanin. Several other studies that did not meet our inclusion criteria corroborated the notion that skin pigmentation results in lower rSo readings.
CONCLUSIONS
Skin pigmentation likely results in attenuated rSo readings. However, the magnitude of this effect may depend on the specific NIRS platform used.
PubMed: 38352943
DOI: 10.1097/CCE.0000000000001049 -
Revista de Neurologia Oct 2023Cladophialophora bantiana is a filamentous fungus, known as a dematiaceous fungus because of the presence of melanin. This fungus is of clinical importance because it is...
INTRODUCTION
Cladophialophora bantiana is a filamentous fungus, known as a dematiaceous fungus because of the presence of melanin. This fungus is of clinical importance because it is neurotropic and causes cerebral phaeohyphomycosis.
MATERIAL AND METHODS
The available scientific information on the development of cerebral phaeohyphomycosis caused by Cladophialophora bantiana was analysed by selecting articles from the PubMed, Scopus and Google Scholar databases that describe case reports of fungal infection by C. bantiana in adults, taking into account the analysis of the patients' symptomatology, clinical history and neuroanatomical damage, in addition to considering the mortality of the condition.
RESULTS
India and United States were the countries with most case reports, with 32 and 11 cases respectively. Moreover, in terms of neuroanatomical lesions, the majority of patients suffered mixed lesions (29%) and frontal lobe lesions (22%). In accordance with the patients' condition, the pathology has a mortality rate of 62%.
CONCLUSIONS
It is concluded that cerebral phaeohyphomycosis has a high mortality rate, there is no standardised treatment and, in most cases, the fungal infection of the brain is mixed and affects several different parts of it. Furthermore, if not diagnosed and treated in time, it can lead to the patients' death.
Topics: Adult; Humans; Antifungal Agents; Ascomycota; Brain Abscess; Cerebral Phaeohyphomycosis; Mycoses; Case Reports as Topic
PubMed: 37807883
DOI: 10.33588/rn.7708.2023145 -
Journal of Racial and Ethnic Health... Dec 2023Wearable consumer technology allows for the collection of a growing amount of personal health data. Through the analysis of reflected LED light on the skin, heart rate...
BACKGROUND
Wearable consumer technology allows for the collection of a growing amount of personal health data. Through the analysis of reflected LED light on the skin, heart rate measurement and arrhythmia detection can be performed. Given that melanin alters skin light absorption, this study seeks to summarize the accuracy of cardiac data from wrist-worn wearable devices for participants of varying skin tones.
METHODS
We conducted a systematic review, searching Embase, MEDLINE, CINAHL, and Cochrane for original studies that stratified heart rate and rhythm data for consumer wearable technology according to participant race and/or skin tone.
RESULTS
A total of 10 studies involving 469 participants met inclusion criteria. The frequency-weighted Fitzpatrick score for skin tone was reported in six studies (n = 293), with a mean participant score of 3.5 (range 1-6). Overall, four of the ten studies reported a significant reduction in accuracy of heart rate measurement with wearable devices in darker-skinned individuals, compared to participants with lighter skin tones. Four studies noted no effect of user skin tone on accuracy. The remaining two studies showed mixed results.
CONCLUSIONS
Preliminary evidence is inconclusive, but some studies suggest that wearable devices may be less accurate for detecting heart rate in participants with darker skin tones. Higher quality evidence is necessary, with larger sample sizes and more objective stratification of participants by skin tone, in order to characterize potential racial bias in consumer devices.
Topics: Humans; Wrist; Heart Rate; Skin Pigmentation; Wearable Electronic Devices
PubMed: 36376641
DOI: 10.1007/s40615-022-01446-9