Chronic Pain and Joint Hypermobility: A Brief Diagnostic Review for Clinicians and the Potential Application of Infrared Thermography in Screening Hypermobile Inflamed Joints.

Joint hypermobility syndromes, particularly chronic pain associated with this condition, including Hypermobile Ehlers-Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorders (HSD), present diagnostic challenges due to their multifactorial origins and remain poorly understood from biomechanical and genomic-molecular perspectives. Recent diagnostic guidelines have differentiated hEDS, HSD, and benign joint hypermobility, providing a more objective diagnostic framework. However, incorrect diagnoses and underdiagnoses persist, leading to prolonged journeys for affected individuals. Musculoskeletal manifestations, chronic pain, dysautonomia, and gastrointestinal symptoms illustrate the multifactorial impact of these conditions, affecting both the physical and emotional well-being of affected individuals. Infrared thermography (IRT) emerges as a promising tool for joint assessment, especially in detecting inflammatory processes. Thermal distribution patterns offer valuable insights into joint dysfunctions, although the direct correlation between pain and inflammation remains challenging. The prevalence of neuropathies among hypermobile individuals accentuates the discordance between pain perception and thermographic findings, further complicating diagnosis and management. Despite its potential, the clinical integration of IRT faces challenges, with conflicting evidence hindering its adoption. However, studies demonstrate objective temperature disparities between healthy and diseased joints, especially under dynamic thermography, suggesting its potential utility in clinical practice. Future research focused on refining diagnostic criteria and elucidating the underlying mechanisms of hypermobility syndromes will be essential to improve diagnostic accuracy and enhance patient care in this complex and multidimensional context.

Potential of using facial thermal imaging in patient triage of flu-like syndrome during the COVID-19 pandemic crisis.

The screening of flu-like syndrome is difficult due to nonspecific symptoms or even oligosymptomatic presentation and became even more complex during the Covid-19 pandemic. However, an efficient screening tool plays an important role in the control of highly contagious diseases, allowing more efficient medical-epidemiological approaches and rational management of global health resources. Infrared thermography is a technique sensitive to small alterations in the skin temperature which may be related to early signs of inflammation and thus being relevant in the detection of infectious diseases. Thus, the objective of this study was to evaluate the potential of facial thermal profiles as a risk evaluator of symptoms and signs of SARs diseases, using COVID-19 as background disease. A total of 136 patients were inquired about the most common symptoms of COVID-19 infection and were submitted to an infrared image scanning, where the temperatures of 10 parameters from different regions of the face were captured. We used RT-qPCR as the ground truth to compare with the thermal parameters, in order to evaluate the performance of infrared imaging in COVID-19 screening. Only 16% of infected patients had fever at the hospital admission, and most infrared thermal variables presented values of temperature significantly higher in infected patients. The maximum eye temperature (MaxE) showed the highest predictive value at a cut-off of >35.9°C (sn = 71.87%, sp = 86.11%, LR+ = 5.18, LR- = 0.33, AUC = 0.850, p < 0.001). Our predictive model reached an accuracy of 86% for disease detection, indicating that facial infrared thermal scanning, based on the combination of different facial regions and the thermal profile of the face, has potential to act as a more accurate diagnostic support method for early COVID-19 screening, when compared to classical infrared methods, based on a single spot with the maximum skin temperature of the face.

Occurrence of Hymenoptera on Sus scrofa carcasses during summer and winter seasons in southeastern Brazil

Considerable importance has been given to nest construction and larval food transport to the nest as a precondition for the eusociality of insects. Most adult hymenopterans feed on liquids, although bees and a few wasps may also feed on pollen. Carrion represents an additional source of protein for some species and they will scavenge for dead animals in the wild. This paper aims at analyzing Hymenoptera visitors on a pig carcass during the process of decomposition, in the summer of 2005 and the winter of 2006 in Brazil, and comparing the results with other studies in the Neotropical region. To our knowledge, this is the first study which described the occurence of Agelaia pallipes, Polybia paulista and Scaptotrigona depilis on decomposing carcasses in southeastern Brazil. It also raises the hypothesis of possible applications of Hymenoptera to achieve more precise PMI estimations, apart from other insects already known as having great importance in such estimates.

Considerável importância tem sido dada às construções de ninhos e transporte de alimento larval para o ninho como uma pré-condição para a eusociabilidade dos insetos. Muitos adultos de himenópteros alimentam-se em líquidos, embora as abelhas e poucas vespas podem também se alimentarem de pólen. Carcaças representam uma fonte adicional de proteína para algumas espécies e elas foram uma vez observadas se alimentando de animais mortos na natureza. Este trabalho tem por objetivo analisar Hymenoptera visitantes em carcaças de porcos durante o verão de 2005 e inverno de 2006 no Brasil, ao longo dos estágios de decomposição, comparando com resultados de outros estudos na região Neotropical. Pelo nosso conhecimento, esse é o primeiro estudo que descreveu a ocorrência de Agelaia pallipes, Polybia paulista e Scaptotrigona depilis em carcaças em decomposição no sudeste do Brasil. Isso também aumenta a hipótese na possibilidade de aplicação de Hymenoptera em auxiliar a estimar o IPM de maneira mais precisa, sem levar em conta insetos que já possuem grande importância forense.