Asociación entre la termografía por infrarrojo y parámetros antropométricos de riesgo cardiometabólico en hombres / Association between infrared thermography, anthropometry and cardiovascular risk parameters in men

RESUMEN: Los parámetros antropométricos para la estimación de la composición corporal son variables comúnmente utilizadas en la identificación de factores de riesgo cardiovascular (FRCV). En este sentido la termografía por infrarrojo (TI) podría ser utilizada como una herramienta que aporte información relevante en la evaluación de los FRCV mediante la estimación de la temperatura superficial en la piel y su relación con medidas antropométricas asociadas a estos factores. El objetivo de este estudio fue determinar la relación de la temperatura superficial de hombres adultos con variables antropométricas asociadas a FRCV. Participaron 64 hombres sanos de 26,4 ± 7,8 años, 76,1 ± 13,3 kg de masa corporal, 171,3 ± 7,2 cm de estatura y 25,9 ± 3,7 kg/m2 de índice de masa corporal (IMC). Se realizaron evaluaciones antropométricas de 6 pliegues cutáneos (tricipital, subescapular, supra-espinal, abdominal, muslo medio y pantorrilla), circunferencia de cintura y cadera, además de mediciones de la temperatura superficial mediante TI en las zonas de medición. Se encontraron relaciones significativas negativas entre la temperatura superficial y las mediciones de los pliegues cutáneos a nivel subescapular, supra-espinal, muslo y pantorrilla (p < 0,01; r = -0,39 a -0,55). La temperatura promedio de la TI de los 6-pliegues, y todas las TI individuales de los pliegues presentaron correlaciones negativas significativas con el IMC, perímetro de cintura, índice cintura cadera, índice cintura estatura y la sumatoria de 6 pliegues cutáneos (p < 0,05; r = -0,35 a -0,65). Se puede concluir que existe una relación entre la temperatura superficial de la piel y algunos parámetros antropométricos de la composición corporal que muestran estar asociados a FRCV, pudiendo ser la TI una herramienta útil para complementar la evaluación de estos parámetros.

SUMMARY: Anthropometric parameters for the estimation of body composition are variables commonly used in the identification of cardiovascular risk factors (CVRFs). In this regard, infrared thermography (IT) could be used as a tool that provides relevant information in the CVRFs assessment by estimating skin surface temperature and its relationship with the anthropometric measures associated with these factors. The aim of this study was to determine the relationship of skin surface temperature in adult men with anthropometric variables associated with CVRFs. The study gathered sixty-four healthy men aged 26.4 ± 7.8 years, 76.1 ± 13.3 kg body mass, 171.3 ± 7.2 cm height and 25.9 ± 3.7 kg/m2 body mass index (BMI). Anthropometric assessments of 6 skinfolds (tricipital, subscapular, suprascapular, supraspinal, abdominal, mid-thigh, and calf), waist and hip circumference were conducted, as well as IT surface temperature measurements at the measurement areas. Significant negative relationships were found between surface temperature and skinfold measurements at the subscapular, supraspinal, thigh and calf levels (p < 0.01; r = -0.39 to -0.55). The average IT temperature of the 6- folds and all individual folds IT had significant negative correlations with BMI, waist circumference, waist hip ratio, waist height ratio, and the sum of 6 skinfolds (p < 0.05; r = -0.35 to -0.65). There is a relationship between skin surface temperature and some body composition anthropometric parameters that indicate and association with CVRFs, therefore, IT may be a useful tool to complement the assessment of these parameters.

Clinical application of thermography for energy balance in athletes - state of the art and new paradigms / Aplicação clínica da termografia para equilibrio energético em atletas - estado da arte e novos paradigmas / Aplicación clínica de la termografia para equilibrio energético en atletas - estado del arte y nuevos paradigmas

This article aims to describe the evolution of techniques that have enabled the proper application of the Laws of Thermodynamics for physical activity and athletes. The objective is to propose performance indicators to help add information to the current indices used in medicine and sports, such as the lactate threshold and maximum oxygen consumption. A number of analyses of the results obtained by the group were carried out for this purpose. Moreover, a discussion regarding which techniques would provide a better response to the measurements was analyzed. Some examples are the substitution of the treadmill running test with the stationary bicycle (known performed work), and a literature search in order to measure internal temperature more accurately. Level of Evidence V; Expert opinion.

Este artigo descreve a evolução de técnicas que possibilitaram a aplicação adequada das Leis da Termodinâmica às atividades físicas e aos atletas. O objetivo é propor indicadores de desempenho que ajudem a acrescentar informações aos índices atuais usados em medicina e nos esportes, como o limiar de lactato e o consumo máximo de oxigênio. Diversas análises dos resultados obtidos pelo grupo foram realizadas com essa finalidade. Além disso, procedeu-se à análise da discussão sobre quais técnicas proporcionariam resposta melhor às medições. Alguns exemplos são a substituição do teste de corrida em esteira pela bicicleta ergométrica (que sabidamente, pode ser usada para o trabalho), e a pesquisa da literatura para medir a temperatura interna com maior precisão. Nível de Evidência V; Opinião de especialista.

Este artículo describe la evolución de técnicas que posibilitaron la aplicación adecuada de las Leyes de la Termodinámica a las actividades físicas y a los atletas. El objetivo es proponer indicadores de desempeño que ayuden a acrecentar informaciones a los índices actuales usados en medicina y en los deportes, como el umbral de lactato y el consumo máximo de oxígeno. Fueron realizados diversos análisis de los resultados obtenidos por el grupo con esa finalidad. Además, se procedió al análisis de la discusión sobre qué técnicas proporcionarían respuesta mejor a las mediciones. Algunos ejemplos son la sustitución del test de carrera en cinta por la bicicleta ergométrica (que sabidamente, puede ser usada para el trabajo), y la investigación de la literatura para medir la temperatura interna con mayor precisión. Nivel de Evidencia V; Opinión de especialista.

Termografia infravermelha na odontologia / Infrared thermography in dentistry

A termografia infravermelha consiste em um exame de imagem complementar aplicada na avaliação da temperatura corporal com base na emissão de radiação infravermelha através da pele, podendo auxiliar no diagnóstico ou monitoramento das intervenções terapêuticas. Trata-se de uma técnica não ionizante e não invasiva que capta e registra a distribuição térmica da superfície cutânea avaliada por meio das alterações na microcirculação dos pacientes frente a diferentes condições patológicas. Dentre as aplicações na Odontologia, a termografia pode complementar o exame físico anatômico, visto que apresenta em tempo real condições fisiológicas, de acordo com a temperatura. Esta técnica pode auxiliar no diagnóstico e planejamento do tratamento de alterações orofaciais, como processos inflamatórios e infecciosos na região orofacial, acompanhamento pós-cirúrgico e na avaliação de pacientes com desordens temporomandibulares (DTM). A termografia ainda é pouco utilizada na Odontologia, e protocolos para avaliação de alterações na região de cabeça e pescoço ainda devem ser testados e estabelecidos. Porém, já mostra ser um exame complementar de boa performance na detecção de pontos gatilho da dor, acompanhamento de pacientes de forma não invasiva e como documentação médico-legal.

Infrared thermography consists of a complementary imaging test applied to the assessment of body temperature based on the emission of infrared radiation through the skin, which may aid in the diagnosis or monitoring of therapeutic interventions. It is a non-ionizing and non-invasive technique that captures and records the thermal distribution of the cutaneous surface evaluated by means of the changes in the patients' microcirculation in face of different pathological conditions. Among the applications in Dentistry, thermography can complement the anatomical physical examination, since it presents in real time physiological conditions according to temperature. This technique can help in the diagnosis and planning of the treatment of orofacial alterations, such as inflammatory and infectious processes in the orofacial region, post-surgical follow-up and in the routine evaluation of patients with temporomandibular disorders (TMD). Thermography is still poorly used in Dentistry and protocols for the evaluation of head and neck disorders have yet to be tested and established. However, it already shows up as a good complementary examination for the detection of pain trigger points, follow-up of patients in a non-invasive way, and as medical-legal documentation.

Infrared thermography to diagnose and manage venomous animal bites and stings

Abstract INTRODUCTION Infrared imaging (IR) is a noninvasive technique that quantifies body surface temperature, producing a digital color image. IR has been used to study diseases in which skin temperature can reflect the presence of inflammation. METHODS This was an observational pilot study of eight patients envenomed by snakes, spiders, and scorpions. All patients were examined using a thermal camera. RESULTS In all cases, we obtained infrared images that corroborated clinical findings indicating localized effects of venom, specifically inflammation. CONCLUSIONS IR has potential for use as a research, diagnostic, and monitoring tool for localized effects of animal venoms.

Profile of infrared thermography in elite soccer players

Abstract Aims The aim of this study was to establish thermographic profiles of lower limbs and to correlate them with creatine kinase level in professional players. Method Thirty healthy male professional soccer players (25.4 ± 4.7 years; 179.5 ± 6.7 cm; 78.3kg ± 7.5 kg; body fat 10.2 ± 4.2 %) from a club of Brazilian first division soccer league volunteered. Thermal images sequences of lower limbs (thighs and legs) were acquired in an anteroposterior manner (i.e., frontal and dorsal views) by a digital infrared thermo-camera. Blood creatine kinase (CK) concentration was assessed by reflectance photometry. All thermographic images and CK were performed between 8:00 and 9:00 am. Results No significant difference (p>0.05) was found between left and right sides from both anterior and posterior measurements of thighs and legs for mean or maximal skin temperature. Low values of correlation (range r=0.14 to r=0.38) was found between skin temperature and CK levels while contralateral thermal symmetry in the lower limbs (regions of interest < 0.2°C) was found. Conclusion It was observed contralateral thermal symmetry in the lower limbs and low correlation between CK and temperature values in elite soccer players.(AU)

Thermographic analysis and autonomic response in the hands of patients with leprosy

Abstract: Background: Low temperatures and slow blood flow may result from peripheral neuropathy caused by leprosy, and the simple detection of cold fingers could already be a preliminary classification for these patients. Objective: To investigate whether infrared thermography would be able to measure this change in temperature in the hands of people with leprosy. Method: The study assessed 17 leprosy patients who were under treatment at the National Reference Center for Sanitary Dermatology and Leprosy, Uberlândia/MG, and 15 people without leprosy for the control group. The infrared camera FLIR A325 and Therma CAM Researcher Professional 2.9 software were used to measure the temperature. The room was air-conditioned, maintaining the temperature at 25°C; the distance between the camera and the limb was 70 cm. The vasomotor reflex of patients was tested by a cold stress on the palm. Results: The study showed a significant interaction between the clinical form of leprosy and temperature, where the control group and the borderline-borderline form revealed a higher initial temperature, while borderline-lepromatous and lepromatous leprosy showed a lower temperature. Regarding vasomotor reflex, lepromatous leprosy patients were unable to recover the initial temperature after cold stress, while those with the borderline-tuberculoid form not only recovered but exceeded the initial temperature. Conclusion: Thermography proved a potential tool to assist in the early detection of neuropathies, helping in the prevention of major nerve damage and the installation of deformities and disabilities that are characteristic of leprosy.

Using thermography for an obstruction of the lower lacrimal system / Utilização da termografia de uma obstrução da via lacrimal baixa

ABSTRACT Obstructions in the lacrimal pathways quite often require accurate and reliable image scanning for confirmation and documentation. Infrared thermal imaging, known as thermography, is a resource that complements diagnosis; it does not require touching the patient or applying contrast materials and has been used in various medical procedures for decades. However, there have been few studies in the literature about its use in ophthalmology. In this paper, the authors have presented a case of dacryocystitis where the obstruction of the lacrimal punctum was so acute that conventional dacryocystography could not be used. The authors have successfully reported the use of thermography as a complementary propaedeutic and will discuss the method they used.

RESUMO As obstruções de vias lacrimais muitas vezes necessitam de exames de imagem precisos e confiáveis para confirmação e documentação diagnóstica. A imagem térmica por infravermelho, conhecida como termografia, é um recurso complementar diagnóstico sem contato e sem contraste, utilizada há décadas em diversas aplicações médicas. Porém, ainda são poucos os estudos na literatura sobre seu uso na oftalmologia. Neste trabalho os autores apresentam um caso de dacriocistite com obstrução dos pontos lacrimais onde não foi possível utilizar a técnica convencional de dacrioscistografia relatando o uso com sucesso da termografia como propedêutica complementar e discutem o método.

Brazilian adaptation of the Functioning after Pediatric Cochlear Implantation (FAPCI): comparison between normal hearing and cochlear implanted children / Adaptação brasileira do questionário Functioning Inventory after Pediatric Cochlear Implantation (FAPCI): comparação entre crianças com audição normal e com implante coclear

OBJECTIVE: Enabling development of the ability to communicate effectively is the principal objective of cochlear implantation (CI) in children. However, objective and effective metrics of communication for cochlear-implanted Brazilian children are lacking . The Functioning after Pediatric Cochlear Implantation (FAPCI), a parent/caregiver reporting instrument developed in the United States, is the first communicative performance scale for evaluation of real-world verbal communicative performance of 2-5-year-old children with cochlear implants. The primary aim was to cross-culturally adapt and validate the Brazilian-Portuguese version of the FAPCI. The secondary aim was to conduct a trial of the adapted Brazilian-Portuguese FAPCI (FAPCI-BP) in normal hearing (NH) and CI children. METHODS: The American-English FAPCI was translated by a rigorous forward-backward process. The FAPCI-BP was then applied to the parents of children with NH (n = 131) and CI (n = 13), 2-9 years of age. Test-retest reliability was verified. RESULTS: The FAPCI-BP was confirmed to have excellent internal consistency (Cronbach's alpha > 0.90). The CI group had lower FAPCI scores (58.38 ± 22.6) than the NH group (100.38 ± 15.2; p < 0.001, Wilcoxon test). CONCLUSION: The present results indicate that the FAPCI-BP is a reliable instrument. It can be used to evaluate verbal communicative performance in children with and without CI. The FAPCI is currently the only psychometrically-validated instrument that allows such measures in cochlear-implanted children. .

OBJETIVO: O principal objetivo do implante coclear (IC) em crianças é permitir o desenvolvimento da capacidade de se comunicar efetivamente. Contudo, não há objetivo nem parâmetros efetivos de comunicação para crianças brasileiras com o implante coclear. O Functioning after Pediatric Cochlear Implantation (FAPCI), instrumento de relato dos pais/prestadores de cuidados desenvolvido nos Estados Unidos, é a primeira escala de desempenho para avaliação do desempenho comunicativo verbal no mundo real de crianças de 2-5 anos com implantes cocleares. Nosso principal objetivo era adaptar e validar a versão do FAPCI em português do Brasil de forma transcultural. Nosso objetivo secundário era fazer um teste da versão do FAPCI adaptada para o português do Brasil (FAPCI-PB) com grupos de crianças com audição normal (AN) e IC. MÉTODOS: O FAPCI em inglês americano foi traduzido por um processo rigoroso de tradução e retrotradução. O FAPCI-PB foi, então, aplicado aos pais das crianças com AN (n = 131) e IC (n = 13) de 2-9 anos. Foi verificada a confiabilidade da reaplicação do teste. RESULTADOS: Confirmou-se que o FAPCI-PB tem excelente coerência interna (alfa de Cronbach > 0,90). O grupo com IC apresentou menores pontuações no FAPCI (58,38 ± 22,6) do que o grupo com AN (100,38 ± 15,2; p < 0,001, teste de Wilcoxon). CONCLUSÃO: Esses resultados indicam que o FAPCI-PB é um instrumento confiável. Pode ser usado para avaliar o desempenho comunicativo verbal em crianças com e sem IC. O FAPCI é, atualmente, o único instrumento validado psicometricamente que possibilita essas medições em crianças com implante coclear. .

Reliability of different methodologies of infrared image analysis of myofascial trigger points in the upper trapezius muscle

BACKGROUND: Infrared thermography is recognized as a viable method for evaluation of subjects with myofascial pain. OBJECTIVE: The aim of the present study was to assess the intra- and inter-rater reliability of infrared image analysis of myofascial trigger points in the upper trapezius muscle. METHOD: A reliability study was conducted with 24 volunteers of both genders (23 females) between 18 and 30 years of age (22.12±2.54), all having cervical pain and presence of active myofascial trigger point in the upper trapezius muscle. Two trained examiners performed analysis of point, line, and area of the infrared images at two different periods with a 1-week interval. The intra-class correlation coefficient (ICC2,1) was used to assess the intra- and inter-rater reliability. RESULTS: With regard to the intra-rater reliability, ICC values were between 0.591 and 0.993, with temperatures between 0.13 and 1.57 °C for values of standard error of measurement (SEM) and between 0.36 and 4.35 °C for the minimal detectable change (MDC). For the inter-rater reliability, ICC ranged from 0.615 to 0.918, with temperatures between 0.43 and 1.22 °C for the SEM and between 1.19 and 3.38 °C for the MDC. CONCLUSION: The methods of infrared image analyses of myofascial trigger points in the upper trapezius muscle employed in the present study are suitable for clinical and research practices. .

Immediate effects of upper thoracic manipulation on the skin surface temperature of the vertebral region in healthy women / Efeitos imediatos da manipulação torácica alta sobre a temperatura superficial cutânea da região vertebral em mulheres saudáveis / Los efectos inmediatos de la alta manipulación torácica de la temperatura superficial de la piel en la región vertebral en mujeres sanas

Manipulation of the spinal column is a manual therapeutic resource characterized by passive thrust of a given joint at a high velocity and low amplitude within the limits of anatomic integrity. The objective of the present study was to assess the immediate effects of upper thoracic manipulation on skin temperature in the vertebral region in healthy women. Thus, a randomized controlled blind trial was realized in the university community. Twenty-six healthy women were randomly allocated into an experimental group (n=13) and a placebo group (n=13). A single session of upper thoracic spine manipulation (segment T3) was performed. Infrared thermography was used to determine changes in skin temperature in the vertebral region. Images were taken prior to, immediately after and both five and 10 minutes after manipulation. Two-way repeated measures analysis of variance with post hoc Bonferroni test was used for inter and intragroup comparisons. The level of significance was set to 5%. No significant differences were found between the different evaluation times in either group (p>0.05). In the intergroup analysis, no statistically significant differences were found in any of the comparisons (p>0.05). Based on the method employed, thoracic spine manipulation of the T3 vertebral segment does not promote changes in skin surface temperature in the region manipulated in asymptomatic individuals.

A manipulação da coluna vertebral é um recurso da terapia manual caracterizado por um impulso passivo de alta velocidade e baixa amplitude dentro dos limites de integridade anatômica de uma articulação (thrust). O objetivo do presente estudo foi avaliar os efeitos imediatos da manipulação torácica alta sobre a temperatura superficial cutânea da região vertebral em mulheres saudáveis. Para tal, foi realizado um estudo clínico randomizado cego na comunidade universitária. Vinte e seis voluntárias saudáveis foram alocadas de forma randomizada em um grupo experimental (n=13) e um grupo placebo (n=13). Uma sessão de manipulação torácica alta (segmento T3) foi realizada. Foi empregada a termografia infravermelha para determinar alterações na temperatura cutânea na região vertebral. Imagens foram capturadas antes, imediatamente após, cinco e dez minutos após a manipulação. Foi usada análise de variância com medidas repetidas (dois critérios) seguida do teste de Bonferroni para as comparações inter e intragrupos. Adotou-se um nível de significância de 5%. Não foi encontrada diferença significativa nas diferentes avaliações ao longo do tempo (p>0,05). Na análise intergrupos, não foi constatada diferença significativa nas comparações realizadas (p>0,05). Com base na metodologia empregada, a manipulação torácica do segmento vertebral T3 não promoveu alterações na temperatura superficial cutânea na região manipulada.

La manipulación de la espina dorsal es un recurso de terapia manual que se caracteriza por un impulso pasivo de alta velocidad y baja amplitud de los límites de integridad anatómica de una articulación (thrust). Esta investigación tuvo por objetivo evaluar los efectos inmediatos de la alta manipulación torácica de la temperatura superficial de la piel en la región vertebral en mujeres sanas. Para eso, se ha realizado un estudio clínico aleatorizado ciego en la comunidad universitaria. Veintiséis voluntarias han sido puestas de forma aleatorizada en un grupo experimental (n=13) y un grupo placebo (n=13). Ha sido realizada una sesión de manipulación torácica alta (segmento T3). Se ha empleado el término infrarrojo para determinar alteraciones en la temperatura de la piel en la región vertebral. Se han capturado imágenes antes, inmediatamente después, cinco y diez minutos tras la manipulación. Se ha hecho un análisis de los cambios con medidas repetidas (dos criterios) seguido de la prueba de Bonferroni para las comparaciones inter e intragrupal. Se ha adoptado un nivel de significancia de 5%. No ha sido encontrado diferencias significativas en las diferentes evaluaciones al largo del tiempo (p>0,05). En el análisis intergrupal, no ha sido constatado diferencias significativas en las comparaciones realizadas (p>0,05). Basándose en la metodología empleada, la manipulación torácica del segmento vertebral T3 no cambió la temperatura superficial de la piel en la región estudiada.

Estudo da distribuição térmica da superfície cutânea facial por meio de termografia infravermelha: termoanatomia da face / Study of the facial surface skin thermal distribution by infrared thermography: facial thermoanatomy

Pelo fato da face ser uma estrutura que envolve multissistemas, ela é considerada anatomica e funcionalmente muito complexa em sua avaliação clínica. Muitos diagnósticos de doenças que afetam a região facial são realizados por meio de métodos de imagem, entretanto, as técnicas convencionais são incompletas, pois apresentam um déficit de informações em relação aos aspectos funcionais, relativos à microcirculação regional e o sistema nervoso autônomo. Para documentação objetiva destas alterações, a termografia por imagem infravermelha tem sido proposta como método auxiliar diagnóstico. O objetivo deste estudo foi identificar, mapear e quantificar pontos de referência baseados na termoanatomia da face, a partir de gradientes térmicos, em uma população adulta. A amostra constituiu-se por 161 voluntários, ambos os gêneros, entre 26 e 84 anos (63 ±15 anos). Foram identificados 28 pontos de referência termoanatômicos fixos em 94,6% da amostra. A temperatura média desses pontos de referência termoanatômicos variou entre 33,3°C a 35,6°C, sendo que o melhor valor de corte para sua correta identificação na face foi acima de 34,5ºC. Não houve diferença estatística quando os comparou entre as hemifaces correspondentes e nem quanto à idade dos voluntários (?T = 0,11°C), exceto entre os gêneros e grupo racial (p<0,05). Concluiu-se que a face apresenta pontos termoanatômicos fixos e confiáveis em adultos, a qual a termografia tem o potencial de auxiliar na identificação de alterações a partir destes pontos...

Anatomical and functional information of the structures of interest are the basis for interpretation of imaging exams. For recognizing diseases it is necessary to understand and identify the anatomical structures and its variations. Diagnosis of some facial diseases may be done through medical imaging techniques; however, the most conventional methods present lack of information regarding physiological and functional aspects such as microcirculation and autonomous nervous system. The aim of this study was to identify, map and quantify the facial thermal gradients (thermo-anatomical points) in healthy adult population. A hundred sixty-one volunteers of both gender and mean age of 63 ±15 years were included. The results showed that twenty eight thermo-anatomical points have been identified in 94.6% of the sample, with a significant difference of the temperature in gender and racial groups (p<0.05). Moreover, there was no statistically significant difference between ages and sides in healthy individuals (?T = 0.11°C). The average temperature of the points ranged from 33.3°C to 35.6°C. When the maximum temperature reached to detect a facial thermal gradient is higher than 34.5°C, the thermo-anatomical point is meant to be correctly delineated. For detection of functional changes from thermoanatomical points on the face, thermography may be used as an auxiliary diagnostic imaging method...

Plantar thermography is useful in the early diagnosis of diabetic neuropathy

OBJECTIVES: This study evaluated plantar thermography sensitivity and specificity in diagnosing diabetic polyneuropathy using cardiac tests (heart rate variability) as a reference standard because autonomic small fibers are affected first by this disease. METHODS: Seventy-nine individuals between the ages of 19 and 79 years old (28 males) were evaluated and divided into three groups: control (n = 37), pre-diabetics (n = 13) and type 2 diabetics (n = 29). The plantar images were recorded at baseline and then minutes after a provocative maneuver (Cold Stress Test) using an infrared camera that is appropriate for clinical use. Two thermographic variables were studied: the thermal recovery index and the interdigital anisothermal technique. Heart rate variability was measured in a seven-test battery that included three spectral indexes (in the frequency domain) and four Ewing tests (the Valsalva maneuver, the orthostatic test, a deep breathing test, and the orthostatic hypotension test). Other classically recommended tests were applied, including electromyography (EMG), Michigan inventory, and a clinical interview that included a neurological physical examination. RESULTS: Among the diabetic patients, the interdigital anisothermal technique alone performed better than the thermal recovery index alone, with a better sensitivity (81.3%) and specificity (46.2%). For the pre-diabetic patients, the three tests performed equally well. None of the control subjects displayed abnormal interdigital anisothermal readouts or thermal recovery indices, which precluded the sensitivity estimation in this sample of subjects. However, the specificity (70.6%) was higher in this group. CONCLUSION: In this study, plantar thermography, which predominately considers the small and autonomic fibers that are commonly associated with a sub-clinical condition, proved useful in diagnosing diabetic neuropathy early. The interdigital anisothermal test, when used alone, performed best.

Efeito vasomotor após intoxicação aguda com bupivacaína e levobupivacaína via intraperitoneal em ratos, analisado por imagem infravermelha digital / Vasomotor effect after acute intoxication with bupivacaine and levobupivacaine in rats via intraperitoneal route analyzed via digital infrared imaging

JUSTIFICATIVA E OBJETIVOS: O estudo do efeito vasomotor dos anestésicos locais (AL) é de suma importância para a análise da ocorrência de efeitos cardiotóxicos, neurotóxicos e interações medicamentosas. Com a finalidade de encontrar um fármaco mais seguro do que a bupivacaína racêmica, o presente estudo teve por objetivo a análise por imagem infravermelha digital do efeito vasomotor da intoxicação aguda da bupivacaína e da levobupivacaína via intraperitoneal em ratos. MÉTODO: Utilizaram-se 30 ratos machos da linhagem Wistar, alocados em três grupos (n = 10) e submetidos a uma injeção intraperitoneal de AL. No Grupo C (Controle), foi realizada injeção intraperitoneal de soro fisiológico 0,9 por cento 1 mL. No Grupo B (bupivacaína), injeção intraperitoneal de bupivacaína racêmica a 0,5 por cento (R50-S50), dose de 20 mg.kg-1 de peso. No Grupo L (levobupivacaína), injeção intraperitoneal de levobupivacaína a 0,5 por cento, excesso enantiomérico (S75-R25) em dose de 20 mg.kg-1 de peso. Procedeu-se à filmagem termográfica contínua desde o momento da pré-injeção até 30 minutos após a injeção. Os resultados das filmagens foram analisados em forma gráfica, verificando-se a temperatura máxima de cada rato e a temperatura média do sistema que abrigava o animal. RESULTADOS: Os resultados da análise gráfica revelaram que não houve diferença entre o Grupo L e o Grupo C, e a temperatura média permaneceu estável durante todo o experimento em ambos os grupos. No Grupo B, houve um fenômeno de aumento de temperatura após a injeção intraperitoneal de bupivacaína. CONCLUSÕES: Os resultados demonstraram que o efeito vasomotor da toxicidade aguda da levobupivacaína foi semelhante ao Grupo C com soro fisiológico, por meio de estudos macroscópicos por filmagem digital infravermelha, e que houve alterações vasomotoras (vasoconstrição) com a intoxicação por bupivacaína em relação ao Grupo C e em relação ao Grupo L.

BACKGROUND AND OBJECTIVES: The study of the vasomotor effect of local anesthetics (LA) is of paramount importance for the analysis of the occurrence of cardiotoxic and neurotoxic effects, and drug interactions. In order to find a safer drug than racemic bupivacaine, this study aimed to analyze digital infrared imaging of acute vasomotor effect of bupivacaine and levobupivacaine in rats intraperitoneally. METHOD: We used 30 male Wistar rats distributed into three groups (n = 10) and subjected to an intraperitoneal injection of LA. In Group C (control) 1 mL 0.9 percent saline was injected intraperitoneally. In Group B (bupivacaine), intraperitoneal injection of 0.5 percent of racemic bupivacaine (S50-R50), dose of 20 mg.kg-1 of body weight. In Group L (levobupivacaine), intraperitoneal injection of levobupivacaine 0.5 percent enantiomeric excess (S75-R25) in dose of 20 mg.kg-1 of body weight. The procedure was thermographicly continuously filmed from the time of pre-injection until 30 minutes after injection. The results of the recordings were analyzed in graphical form, verifying the maximum temperature of each rat and the average temperature of the system that housed the animal. RESULTS: The results of graphic analysis showed no difference between Group L and Group C, and the average temperature remained stable through-out the experiment in both groups. In Group B, there was a phenomenon of temperature increase after intraperitoneal injection of bupivacaine. CONCLUSIONS: The results demonstrated that the vasomotor effect of the acute toxicity of levobupivacaine was similar to Group C with saline, through macroscopic studies by infrared digital filmmaking, and that there were vasomotor changes (vasoconstriction), with bupivacaine intoxication in relation to both Group C and Group L.

JUSTIFICATIVA Y OBJETIVOS: El estudio del efecto vasomotor de los anestésicos locales (AL), es de suma importancia para el análisis del aparecimiento de efectos cardiotóxicos, neurotóxicos e interacciones medicamentosas. Con el fin de encontrar un fármaco más seguro que la bupivacaína racémica, el presente estudio se propuso analizar por imagen infrarroja digital, el efecto vasomotor de la intoxicación aguda de la bupivacaína y de la levobupivacaína vía intraperitoneal en ratones. MÉTODO: Fueron usados 30 ratones machos de la raza Wistar, divididos en tres grupos (n = 10) y sometidos a una inyección intraperitoneal de AL. En el Grupo C (Control), fue realizada una inyección intraperitoneal de suero fisiológico al 0,9 por ciento 1 mL. En el Grupo B (bupivacaína), una inyección intraperitoneal de bupivacaína racémica al 0,5 por ciento (R50-S50), dosis de 20 mg.kg-1 de peso. En el Grupo L (levobupivacaína), una inyección intraperitoneal de levobupivacaína al 0,5 por ciento, con exceso enantiomérico (S75-R25) en dosis de 20 mg.kg-1 de peso. Después de procedió a la filmación termográfica continua desde el momento anterior a la inyección hasta 30 minutos después de ella. Los resultados de las filmaciones se analizaron de forma gráfica, verificando la temperatura máxima de cada ratón y la temperatura promedio del sistema que abrigaba al animal. RESULTADOS: Los resultados del análisis gráfico revelaron que no hubo diferencia entre el Grupo L y el Grupo C, y que la temperatu-ra promedio se mantuvo estable durante todo el experimento en los dos grupos. En el Grupo B, se produjo un fenómeno de aumento de temperatura después de la inyección intraperitoneal de bupivacaína. CONCLUSIONES: Los resultados demostraron que el efecto vasomotor de la toxicidad aguda de la levobupivacaína fue similar al Grupo C con suero fisiológico, por medio de estudios macroscópicos por filmación digital infrarroja, y que se produjeron alteraciones vasomotoras (vasoconstricción)...

Infrared imaging contribution for intestinal ischemia detection in wound healing / Contribuição da imagem infravermelha para detecção da isquemia intestinal na cicatrização das feridas

PURPOSE: To study thermal variations obtained through infrared image in rats, and to evaluate the relationship between intestinal ischemic time and histopathological findings. METHODS: Thirty Wistar rats were operated after distribution in 5 groups with different times of ischemia. Thermograms were obtained by using a infrared camera. The surgical technique has been standardized for all groups: abdominal cavity opening by a 5cm length incision in the midline, abdominal wall plans section and cavity exposure, and exteriorization of the intestine. In group I (control), it was proceeded only laparotomy without superior mesenteric artery ligature. After first thermogram done, incision was closed with continuing suture. In each rat in groups II, III, IV and V, the superior mesenteric artery was located at its origin on abdominal aorta, dissected and occluded with a vascular microclamp, subjecting the intestine to ischemia in variable times. RESULTS: Rats submitted to a 30 minutes ischemia presented reactive hyperemia, thermal differential of 1.8°C and normal pathological examination. The 1 hour ischemia produced reactive hyperemia with ischemic areas, thermal differential of 1.0°C and injuries at villosities' tips. However, the 90 minutes ischemia had not shown reactive hyperemia with large ischemic areas, thermal differential of -1.0°C and injury in the upper third of the villosities. The 2 hours ischemia demonstrated a severe ischemia, thermal differential of -2.0°C and injury throughout the all villosities' extension. CONCLUSION: It has been possible studying thermal variations through infrared image in rats, showing correlation between thermal response in thermograms, ischemic time and histopathological findings.

OBJETIVO: Estudar as variações térmicas obtidas por meio da imagem infravermelha em ratos, e avaliar sua correlação com o tempo de isquemia intestinal e os achados histopatológicos. MÉTODOS: Trinta ratos Wistar foram operados após distribuição em cinco grupos com diferentes tempos de isquemia. Os termogramas foram obtidos utilizando-se uma câmera infravermelha. A técnica operatória foi padronizada para todos os grupos, abertura da cavidade abdominal por uma incisão na linha média de 5 cm de comprimento com secção de todos os planos da parede abdominal e exposição da cavidade e as alças intestinais exteriorizadas. No grupo I (controle) foi feito apenas laparotomia sem ligadura da artéria mesentérica superior. Após realizado o primeiro termograma, foi fechada a incisão com sutura contínua. Em cada rato dos grupos II, III, IV e V a artéria mesentérica superior foi localizada em sua origem na aorta abdominal, dissecada com e ocluída por um microclampe vascular submetendo o intestino à isquemia em tempos variáveis. RESULTADOS: Os ratos submetidos à isquemia de 30 minutos apresentaram hiperemia reativa, diferencial térmico de 1,8°C e exame anatomopatológico normal. A isquemia de 1 hora produziu hiperemia reativa com áreas de isquemia, diferencial térmico de 1,0°C e lesões na ponta das vilosidades. Já a de 90 minutos não demonstrou hiperemia reativa com grandes áreas de isquemia, diferencial térmico de -1,0°C e lesão no terço superior das vilosidades. A isquemia de 2 horas mostrou isquemia grave, diferencial térmico de -2,0°C e lesão em toda a extensão das vilosidades. CONCLUSÃO: Foi possível estudar as variações térmicas por meio da imagem infravermelha em ratos, que mostrou haver correlação entre a resposta térmica dos termogramas, o tempo de isquemia e achados histopatológicos.

Análise dos efeitos imediatos da terapia craniossacra em portadores de disfunções craniomandibulares através do exame de termografia e avaliação fisioterapêutica / Analysis fo the immediate effects of craniosacral therapy in patients with craniomanbdibular disfunctions though termography and physical therapy evaluation

O objetivo do estudo foi analisar os efeitos imediatos da terapia craniossacra em pacientes com disfunção craniomandibular (DCM) e verificar os resultados através do exame de termografia infravermelha e da avaliação fisioterapêutica. Estudo de nove mulheres com diagnóstico de DCM. As participantes responderam questionário. A avaliação fisioterapêutica foi composta por mensuração da amplitude de movimento (ADM)da abertura da boca com paquímetro, testes cinesiológicos, palpação muscular e da articulação temporomandibular (ATM) e as participantes responderam questionário. A termografia analisou a simetria da temperatura dos músculos e foi realizada antes da avaliação e reavaliação fisioterapêutica. A análise comparativa dos resultados foi realizada através de gráficos e testes estatísticos não paramétricos WILCOXON. Na avaliação da abertura bucal houve melhora na ADM e os resultados foram significativos estatisticamente (p<0,05). Na análise da queixa dolorosa todas as pacientes (100%) relataram melhora. Houve diminuição dos sintomas cefaléia e dor de ouvido em 60% dos pacientes. Declararam diminuição da dor na face 56%, zumbido 42%, e vertigem 40% dos participantes. Referiram diminuição da dor na ATM e nos músculos mastigatórios 34% dos pesquisados. Houve melhora do estalido e hipoacusia em 34% e cervicalgia em 28% dos pacientes. Na análise através da termografia houve melhora estatisticamente significativa (p<0,05) nos músculos masseter e esternocleidomastoideo. Nos escalenos, digástricos, trapézios e temporais não foram encontradas alterações significativas. A fisioterapia osteopática utilizando técnicas de terapia craniossacra promove resultados positivos no tratamento das DCM e torna-se necessária na abordagem multiprofissional desses pacientes. A termografia se mostrou importante na análise dos resultados.

The aim of this study was to analize the immediate effects of craniosacral therapy in patients with temporomandibular disfunction (TMD) and verify the results through infrared thermography and physical therapy evaluation. Study of nine women with TMD. The participants answered a questionnaire. The physical therapy evaluation was made by measuring the range of motion (ROM) of tempomandibular joint using a pakimeter. It was also user kinesiological and strenght muscle tests, muscle and temporomandibular joint (TMJ) palpation. The thermography analized the avarage temperature of the muscles and it was made before the physical therapy evaluation and reevaluation. The comparative analysis of the results was accomplished using graphs and WILCOXON non parametric statistical tests. There was an increase in the range of motion of the TMJ and the results were statistically significant (p<0.05). In the pain analysis 100% of the patients stated that there was a decrease in the symptoms. There was a decrease symptoms of headache and ear pain in 60% of the patients. 56% of the patients stated a decrease in face pain, 42% stated a decrease in ear ringing and 40% of the patients stated a decrease in dizzines symptoms, 34% of the patients stated a decrease in temporomandibular joint pain and 34% of the patients showed hipoacusia decreasing and 28% neck pain. The thermografy provided as a result statistically improvement (p<0.05) for the masseter and sternocleidomastid muscles. No improvements for scalenus, digastricus, trapezius and temporalis muscles was observed. The osteopathic physiotherapy utilizing craniosacral technics showed positive results on craniomandibular disfunction treatment. It is also important multiprofissional corroboration. The infrared thermography showed to be important to analyse the results.

Comparison of tympanic and rectal temperature in febrile patients.

OBJECTIVE: To compare tympanic membrane temperature and rectal temperature in febrile pediatric patients. METHODS: Sixty febrile children were enrolled as continuous enrollment at initial triage. Two readings of ear temperature were taken in each child with Thermoscan infrared thermometer. Rectal temperature was recorded by a digital electronic thermometer. Comparison of both the techniques was done and co-relation co-efficients calculated. Parental preference for both techniques was assessed. RESULTS: It was observed that mean ear temperature was 38.9+/-0.90 C and that for rectal temperature was 38.8+/-0.80 degrees C. The correlation coefficient between the two was 0.994 (p < 0.01). Coefficients for both sites were comparable over a wide age range. The difference between readings taken from two ears was not significant. Temperature ranges over which readings were recorded were quite wide for both techniques. Parental preference for tympanic thermometry over rectal thermometry was noticed. Tympanic thermometry utilizes pyro-electric sensors, to detect infra-red rays emitted from the surface of tympanic membrane. Ear temperatures correlates well with rectal temperatures which have long been considered as "core" temperatures. Parents prefer the technique of ear thermometry which is quick (2 sec), safe and non-invasive and patient resistance for this is also less. CONCLUSION: A non-invasive, non-mucous device which is accurate over a wide range of temperature could be very useful.

Digital infrared thermographic imaging in patients with gastroesophageal reflux disease

We performed a thermographic study to observe any possible interaction between the esophageal acid perfusion and the temperature changes of skin surface in patients with gastroesophageal reflux disease (GERD). Twenty-seven patients with GERD were categorized as group I(globus symptoms with posterior laryngitis) and group II (heartburn and/or regurgitation symptoms). Patients and 6 healthy volunteers underwent Bernstein test (BT) and digital infrared thermographic imaging (DITI) simultaneously. The positive rate for BT in group I and group II was 22.2% and 55.6%, respectively, and the DITI positive rate was 55.6% for group I and 50.0% for group II. None of healthy control were positive in BT or DITI. All subjects with DITI positive were hypothermic. The overall accordance rate between DITI and BT was 69.7%. All group I patients showed a diffuse type, while in group 11, 4 patients showed diffuse type and 5 patients showed localized type (p<0.05). In patients with DITI (+)/BT (-), 83.3% showed diffuse type, whereas equal numbers of diffuse and localized type were noted in patients with DITI (+)/BT (+). In conclusion, add contact with a sensitive mucosa leads to an activation of the sympathetic nervous system in some patients with GERD, inducing skin surface hypothermia.

Assessment of inflammation in the rheumatoid knee joint: correlation between clinical, laboratory and thermographic methods

The present study was done to evaluate the role of thermography in assessment of inflammation in rheumatoid knee patient. Also, a trial to find a correlation between thermographic index and disease activity. The subjects of this study included thirty patients suffering of rheumatoid arthritis [24 females and 6 males]. They are selected from the outpatient clinic of Rheumatology and Rehabilitation Department at Zagazig University Hospital, and diagnosed according to American Rheumation Association, revised criteria [Arnett et al., 1988]. Their ages ranged from 23 - 55 years, with a mean [37.7 +/- 11.28] years and the disease duration ranged from 7 months - 8 years with mean [3.4 +/- 1.3 years]. All of these patients suffer from active synovitis of one or both knee. Ten healthy individuals [4 males and 6 females], were chosen as control for thermography. From the study we found abnormal thermal pattern in the knee of rheumatoid patients as they were in activity. Also, we found a highly significant correlation between thermographic index and mean disease activity grades [Mallya score [P < 0.001]. Thermography was found to be an objective method for measuring the degree of inflammation in different joints of RA. It was simple, sensetive, safe, reproducible and capable of monitoring changes in disease activity over time

Comparison of sympathetic skin response and digital infrared thermographic imaging in peripheral neuropathy

It is well known that the SSR (sympathetic skin response) is to evaluate the function of sudomotor activity and Digital infrared thermal imaging (DITI) is to evaluate the function of vasomotor activity of the sympathetic nerve. To assess the sympathetic nerve impairment in the patients with peripheral neuropathy, the SSRs and DITIs were tested in 35 cases. Twenty-four (68.6%) patients were abnormal on SSR test and twenty-nine (82.9%) patients were abnormal on DITI test. In the relationship between DITI and SSR, 19 (54.3%) cases were abnormal and 1 case was normal finding in both of these two tests. And the remaining 25 (42.9%) patients were abnormal on only either one of both tests. Frequency of abnormal SSR and DITI findings were correlated with severity of axonal involvement in peripheral nerve lesion. The results of this study revealed DITI to be more sensitive test in assessing sympathetic dysfunction in peripheral neuropathy than the SSR. However DITI has very limited values in the patients with symmetrically involved peripheral neuropathy because thermal asymmetry is considered as abnormal on DITI. Therefore, in assessing the function of sympathetic nerve in peripheral neuropathy, combined tests of SSR and DITI are useful.