Relationship between aerobic fitness and lower limb skin temperature during cycling exercise testing among well-trained athletes and nonathletes: a cross-sectional study.

Background: During prolonged physical exercise, the skin plays an important role in thermoregulation by dissipating heat to maintain core temperature. Moreover, thermal variation may be influenced by the physical fitness level of an individual. The aim of the present study was to determine the relationship between aerobic fitness and lower limb skin temperature during graded cycling exercise testing in well-trained athletes and nonathletes. Methods: Twelve trained athletes (mean ± SD maximal oxygen consumption [VO2max], 52.44 ± 4.5 ml/kg/min) and 12 nonathletes (VO2max, 36.95 ± 4.9 ml/kg/min) participated in this study. The regional skin temperature over the lower limbs was monitored continuously during incremental exercise testing using a thermal camera, and cardio-respiratory parameters were assessed and recorded using a metabolic analyzer (K5, COSMED, Rome, Italy). Results: The mean skin temperature of athletes at a high intensity of exercise was 27.23 ± 0.3 °C while that of nonathletes was 29.03 ± 0.44 °C, a difference that was statistically significant (p < 0.05). A negative correlation was observed between skin temperature and cardiovascular parameters (VO2max and heart rate) in athletes, while no such correlation was found among nonathletes. Conclusion: The present study demonstrated a negative correlation between oxygen consumption and lower limb skin temperature in athletes, while the correlation was poor in nonathletes. This suggests that physical fitness level may influence the pattern of alterations in lower limb skin temperature, which supports the hypothesis that athletes exhibit better heat dissipation mechanisms than nonathletes.

Thermal imaging in rheumatoid arthritis knee joints and its correlation with power Doppler ultrasound.

Background: Power Doppler ultrasound (PDUS) is an established non-invasive modalities for quantification of inflammation, which has a bearing on the assessment of disease activity in rheumatoid arthritis (RA). However, PDUS has several disadvantages including cost of equipment, steep learning curve and inter-observer variability. Thermal imaging has emerged as a simple, powerful tool for mapping the heat distribution pattern and has the potential to document and quantify disease activity in RA. The objective was to study the thermal imaging pattern of inflamed knee joints in cases of RA and its correlation with PDUS. Methods: This pilot case-control study was carried out at the rheumatology centre in India including 100 subjects (50 controls and 50 RA patients). All participants underwent thermal imaging and PDUS for the knee joints. The mean temperatures in area of interest in knee, thigh and knee-thigh differential were analysed in comparison with PDUS findings. Results: RA subjects had significantly higher mean knee temperature and mean knee-thigh temperature differential compared with controls (p value < 0.00001). PDUS documented inflammation strongly correlated with knee-thigh temperature differential. Conclusion: There was a statistically significant difference in mean knee temperature as well as mean knee-thigh temperature differential of inflamed versus control knees. Thermal imaging has the potential to become simple, objective, cost-effective and reliable tool for diagnosis and assessment of disease activity in inflammatory arthritis.

Monogenic lupus with neuroregression in an infant due to rare compound heterozygous variants in C1QA gene: Case based review.

BACKGROUND: Monogenic lupus is a rare variant of systemic lupus erythematosus (SLE) that develops in patients with a single gene disorder. Early complement component deficiencies were the first forms of monogenic lupus to be described and C1Q gene mutations are one of the most common forms. C1QA complement deficiency has been reported to occur usually due to biallelic variants in C1QA gene and compound heterozygous variants in C1QA gene have rarely been reported. Majority of the monogenic lupus patients with C1Q deficiency present with mucocutaneous, renal, and musculoskeletal manifestations. Our patient is an unusual case of monogenic lupus with severe neurological manifestations along with cutaneous, haematological, and hepatic manifestations secondary to rare compound heterozygous variants in C1QA gene and anti-ribosomal P autoantibody positivity. She was treated with glucocorticoids, rituximab and fresh frozen plasma with partial neurological recovery. Thus, we present a unique case of monogenic lupus due to a rare compound heterozygous variant in C1QA gene with a brief review of literature.

Scrub typhus: a case report.

Fever with rash is a common cause for dermatological referral. The causes can range from viral to protozoal, bacterial or spirochaetal. A case of rickettsial fever is reported.