RESUMO
Infrared thermography (IRT) is a well-known imaging technique that provides a non-invasive displaying of the ocular surface temperature distribution. Currently, compact smartphone-based IRT devices, as well as special software for processing thermal images, have become available. The study aimed to determine the possible use of smartphone-based IRT devices for real-time ocular surface thermal imaging. This study involved 32 healthy individuals (64 eyes); 10 patients (10 eyes) with proliferative diabetic retinopathy (PDR) and absolute glaucoma; 10 patients (10 eyes) with PDR, who underwent vitreoretinal surgery. In all cases, simultaneous ocular surface IRT of both eyes was performed. In healthy individuals, the ocular surface temperature (OST) averaged 34.6 ± 0.8 °C and did not differ substantially between the paired eyes, in different age groups, and after pupil dilation. In our study, high intraocular pressure was accompanied by a decrease in OST in all cases. After vitreoretinal surgery in cases with confirmed subclinical inflammation, the OST was higher than the baseline and differed from that of the paired eye by more than 1.0 °C. These results highlight that smartphone-based IRT imaging could be useful for the non-invasive detection of OST asymmetry between paired eyes due to increased intraocular pressure or subclinical inflammation.
Assuntos
Olho , Raios Infravermelhos , Smartphone , Termografia , Humanos , Termografia/instrumentação , Termografia/métodos , Adulto , Pessoa de Meia-Idade , Masculino , Feminino , Olho/diagnóstico por imagem , Idoso , Adulto Jovem , Retinopatia Diabética/diagnóstico por imagem , Retinopatia Diabética/fisiopatologia , Retinopatia Diabética/diagnóstico , Glaucoma/diagnóstico por imagem , Glaucoma/fisiopatologiaRESUMO
Infrared thermography is considered a useful technique for diagnosing several skin pathologies but it has not been widely adopted mainly due to its high cost. Here, we investigate the feasibility of using low-cost infrared cameras with microbolometer technology for detecting skin cancer. For this purpose, we collected infrared data from volunteer subjects using a high-cost/high-quality infrared camera. We propose a degradation model to assess the use of lower-cost imagers in such a task. The degradation model was validated by mimicking video acquisition with the low-cost cameras, using data originally captured with a medium-cost camera. The outcome of the proposed model was then compared with the infrared video obtained with actual cameras, achieving an average Pearson correlation coefficient of more than 0.9271. Therefore, the model successfully transfers the behavior of cameras with poorer characteristics to videos acquired with higher-quality cameras. Using the proposed model, we simulated the acquisition of patient data with three different lower-cost cameras, namely, Xenics Gobi-640, Opgal Therm-App, and Seek Thermal CompactPRO. The degraded data were used to evaluate the performance of a skin cancer detection algorithm. The Xenics and Opgal cameras achieved accuracies of 84.33% and 84.20%, respectively, and sensitivities of 83.03% and 83.23%, respectively. These values closely matched those from the non-degraded data, indicating that employing these lower-cost cameras is appropriate for skin cancer detection. The Seek camera achieved an accuracy of 82.13% and a sensitivity of 79.77%. Based on these results, we conclude that this camera is appropriate for less critical applications.
Assuntos
Algoritmos , Estudos de Viabilidade , Raios Infravermelhos , Neoplasias Cutâneas , Termografia , Humanos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/diagnóstico por imagem , Termografia/métodos , Termografia/instrumentaçãoRESUMO
SIGNIFICANCE: The need for regulatory review of infrared thermographs (IRTs) used on humans was removed in response to the unique circumstances of the SARS-CoV-2 pandemic (a.k.a., COVID-19). The market for these devices has since expanded considerably. This evaluation of IRT performance may have significant implications for febrility screening worldwide. AIM: Perform controlled nonhuman trials of IRT devices to identify and quantify deviations in the human temperature range. APPROACH: We compared IRT readings of a temperature-controlled non-human subject with one FDA-cleared IRT and one FDA-cleared handheld NCIT. In individual trials for each device, the subject was measured between 35°C and 40°C at 0.25°C increments. RESULTS: The IRT device measurements were consistently normalized around the human mean (â¼37 ° C). Temperatures were decremented as they approached the febrile range, and systematically reported as normal across all seven devices. This effect does not appear to be explained by a fixed offset or any known approach to estimating body temperature, or by random error. CONCLUSION: The IRTs in this study generated human temperature measurements that were systematically biased to the mean human temperature. Given that these devices are utilized for sentinel detection of possible infectious disease transmission, and are now globally employed, the implications for reduced detection of febrility are a widespread false sense of security. This vulnerability must be considered with respect to facility access control, clinical applications, and travel screening in the context of the ongoing COVID-19 pandemic response.
Assuntos
Temperatura Corporal , COVID-19/complicações , Febre/diagnóstico , Termografia/métodos , Febre/etiologia , Humanos , Programas de Rastreamento , SARS-CoV-2 , Termografia/instrumentaçãoRESUMO
INTRODUCTION: Infrared thermography allows the detection of infrared radiation which can be reliably associated with skin temperature. Modern portable thermography devices have been used to identify the location of skin perforators by detecting subtle differences in skin temperature. The aim of this study is to conduct a diagnostic accuracy systematic review to determine the specificity and sensitivity of infrared thermography. MATERIALS AND METHODS: A PRISMA-compliant systematic review and meta-analysis was conducted, scrutinising PUBMED and EMBASE databases for diagnostic studies measuring the accuracy of infrared thermography for perforator identification. Article screening, review and data gathering was conducted in parallel by two independent authors. Eligible studies were subject to a formal risk of bias was assessment using the QUADAS2 instrument. RESULTS: A total of 254 entries were obtained, of which 7 satisfied our pre-established inclusion criteria. These studies reported a total of 435 perforators in 133 individuals. The most commonly investigated locations were the antero-lateral thigh and abdominal wall. Reported sensitivity values ranged from 73.7% to 100%. A meta-analysis demonstrated a cumulative sensitivity of 95%. Specificity was not routinely reported. All studies presented a moderate to high risk of bias according to QUADAS2. DISCUSSION: Affordable infrared thermography devices are an interesting alternative to traditional preoperative investigations for perforator mapping. They are sensitive enough to reliably identify a large proportion of perforators as "hot-spots". However, there is limited evidence to estimate the specificity of this technology, as studies have failed to report true negative values associated with "cold-spots".
Assuntos
Raios Infravermelhos , Retalho Perfurante , Pele/diagnóstico por imagem , Termografia , Precisão da Medição Dimensional , Humanos , Retalho Perfurante/irrigação sanguínea , Retalho Perfurante/transplante , Cirurgia Plástica/métodos , Termografia/instrumentação , Termografia/métodos , Termografia/normas , Coleta de Tecidos e ÓrgãosAssuntos
COVID-19/diagnóstico , Programas de Rastreamento , Telemetria , Termografia , Temperatura Corporal , COVID-19/epidemiologia , COVID-19/prevenção & controle , Precisão da Medição Dimensional , Humanos , Programas de Rastreamento/instrumentação , Programas de Rastreamento/métodos , Tecnologia de Sensoriamento Remoto , Reprodutibilidade dos Testes , SARS-CoV-2 , Telemetria/instrumentação , Telemetria/métodos , Centros de Atenção Terciária , Texas , Termografia/instrumentação , Termografia/métodosRESUMO
Abstract Objective: To evaluate the reliability of infrared (IR) thermal camera connected to smartphones, already used in medicine for diagnostic purposes, as an easy tool for access screening to pediatric dentistry services. Material and Methods: After the preventive telephone triage, thirty orthodontic patients (7-13 years) underwent temperature measurement in the office with two no-contact IR devices: forehead digital thermometer and thermal-camera connected to a smartphone (reference areas: forehead, inner canthi, ears). Measurements were compared and differences were statistically investigated with T student's test (p<0.01). Results: Forehead digital thermometer temperatures were superimposable to those recorded in ear areas and inner canthi with the thermal camera connected to a smartphone. Differences were not statistically significant even in comparison between the sexes. Forehead temperature values detected with a thermal camera are lower than those detected with a digital forehead thermometer. Conclusion: Thermal camera on a smartphone could be reliable in measuring body temperature. Mobile thermographic values of ears and inner canthi areas can be used as an alternative to forehead digital thermometer measurements. Further applications in pediatric dentistry of thermography on smartphones should be examined.
Assuntos
Humanos , Masculino , Feminino , Criança , Temperatura Corporal , Termografia/instrumentação , Odontopediatria , Análise Diferencial Térmica/instrumentação , COVID-19 , Interpretação Estatística de Dados , Smartphone , Itália/epidemiologiaRESUMO
PURPOSE: Small-scale models that simulate large-scale freezing of bulk drug substance of biopharmaceuticals are highly needed to define freezing and formulation parameters based on process understanding. We evaluated a novel scale-down device (SDD), which is based on a specially designed insulation cover, with respect to changes in concentration after freezing, referred to as cryoconcentration, and 3D temperature profiles. Furthermore, the effect of the initial monoclonal antibody (mAb) concentration on cryoconcentration was addressed. METHODS: 2 L and 125 mL bottles were utilized. Temperatures were mapped using type T thermocouples. Frozen blocks were cut and mAb and histidine concentrations were analysed by HPLC. In addition, concentration- and temperature-dependent viscosities were measured. RESULTS: 3D freezing profiles in the SDD were comparable to large-scale bottles. The SDD accurately predicted cryoconcentration of both mAb and histidine of large-scale freezing. Concentric changes in concentration were evident as well as an unforeseen diluted core at the last point to freeze. At low initial mAb concentration cryoconcentration was substantial, while high initial mAb concentration suppressed cryoconcentration almost completely. CONCLUSION: The novel SDD gives detailed insights into large-scale freezing of mAb solutions using only a fraction of the simulated volume. It is a promising material- and cost-saving tool to understand large-scale freezing processes.
Assuntos
Anticorpos Monoclonais/química , Desenho de Equipamento/instrumentação , Proteínas/química , Termografia/instrumentação , Anticorpos Monoclonais/análise , Congelamento , Histidina/análise , Histidina/química , Cinética , Proteínas/análise , Soluções , TemperaturaRESUMO
One of the main functions of infrared thermography (IRT) consists in detecting temperature changes in organisms caused by variations in surface blood circulation. IRT is a useful tool that has been used mainly as a diagnostic method for various stress-causing pathologies, though recent suggestions indicate that it can be used to assess the block quality of certain body regions. In the field of anaesthesiology, IRT has been applied to brachial and epidural blocks, while in algology, changes in surface blood circulation associated with sympathetic activity have been investigated. Thermography has also been employed to complement pain level scales based on the facial expressions of patients in critical condition, or after surgery. In addition, it has been used as a tool in research designed to evaluate different surgical procedures in human medicine, as in the case of surgical burrs for placing dental implants, where IRT helps assess the degree of heating associated with bone devascularisation, reduction in vascular perfusion as a consequence of stroke, and changes in the autonomous nervous system, or the degree of vascular changes in flaps applied to burn patients. In veterinary medicine, thermography has brought several benefits for animals in terms of evaluating lesions, diseases, and surgical procedures. The aim of this review is to evaluate how IRT can be used as a tool in surgical procedures, cases of vascular change, and pain monitoring in veterinary medicine with an emphasis on small animals.
Assuntos
Hemodinâmica , Dor/diagnóstico , Termografia/métodos , Animais , Humanos , Raios Infravermelhos , Microcirculação , Dor/veterinária , Temperatura Cutânea , Termografia/instrumentação , Termografia/veterinária , Medicina Veterinária/métodosRESUMO
BACKGROUND: The large differences of electrical characteristics can be used to reflect the physiological and pathological changes about biological tissues, and it can provide evidence for the early diagnosis and treatment of cancer in potential applications. OBJECTIVE: This paper describes a method called Applied Current Thermoacoustic Imaging (ACTAI) and explores the theory and demonstrates a low conductivity numerical simulation and fresh pork experimental studies. METHODS: In this paper, firstly, the principle of ACTAI is studied. In ACTAI, a target is applied with a microsecond width Gaussian pulse current. Then the target absorbs Joule heat and expands instantaneously, sending out thermoacoustic waves. The waves contain the conductivity information of the target. The waves received by sound transducers are processed by the time inversion method to reconstruct the sound source distribution of the target to illustrate the conductivity information of the target. Secondly, a square model with low conductivity was used as a target to conduct numerical simulation of ACTAI. Lastly, a fresh pork experiment study was conducted. RESULTS: The presented experimental results suggest that ACTAI can identify the conductivity changes information of the target with perfect imagery contrast and deep penetration. CONCLUSION: The ACTAI modality would benefit from the noncontact measurement and can be convenient for clinical application.
Assuntos
Acústica/instrumentação , Termografia/instrumentação , Termografia/métodos , Carne de Porco/análise , Processamento de Sinais Assistido por Computador/instrumentaçãoRESUMO
Background: Breast cancer is the most common cancer in women. While mammography is the standard for early detection in women older than 50 years of age, there is no standard for younger women. The aim of this prospective pilot study was to assess liquid crystal contact thermography, using the Braster device, as a means for the early detection of breast cancer. The device is intended to be used as a complementary tool to standard of care (sonography, mammography, etc). Patients and Methods: A total of 274 consecutive women presenting at Polish breast centers for prophylactic breast examination were enrolled to receive thermography; 19 were excluded for errors in thermographic image acquisition. The women were divided according to age (n = 135, <50 years; n = 120, ≥50 years). A control population was included (n = 40, <50 years; n = 23, ≥50 years). The primary endpoint, stratified by age group, was the C-statistic for discrimination between breast cancer and noncancer. Results: In women with abnormal breast ultrasound (n = 95, <50 years; n = 87, ≥50 years), the C-statistic was 0.85 and 0.75, respectively (P = .20), for discrimination between breast cancer and noncancer. Sensitivity did not differ (P = .79) between the younger (82%) and older women (78%), while specificity was lower in the older women (60% vs 87%, P = .025). The false-positive rate was similar in women with normal and abnormal breast ultrasound. Positive thermographic result in women with Breast Imaging Reporting and Data System (BIRADS) 4A on ultrasound increased the probability of breast cancer by over 2-fold. Conversely, a negative thermographic result decreased the probability of cancer more than 3-fold. Breast size and structure did not affect the thermography performance. No adverse events were observed. Conclusions: Thermography performed well in women <50 years of age, while its specificity in women ≥50 years was inadequate. These promising findings suggest that the Braster device deserves further investigation as a supporting tool for the early detection of breast cancer in women younger than 50 years of age.
Assuntos
Neoplasias da Mama/diagnóstico , Mama , Detecção Precoce de Câncer/métodos , Cristais Líquidos , Termografia , Fatores Etários , Mama/patologia , Mama/fisiopatologia , Equipamentos para Diagnóstico , Desenho de Equipamento , Feminino , Humanos , Pessoa de Meia-Idade , Projetos Piloto , Reprodutibilidade dos Testes , Termografia/instrumentação , Termografia/métodosRESUMO
INTRODUCTION: The goal of this study was to determine the skin surface temperatures of the head using thermography in 28 German Holstein heifer calves at the time of hot iron disbudding. Calves were divided into group 1 (hot-iron disbudding, n = 14) and 2 (sham disbudding, n = 14). Thermographic measurements were made at eight locations of the head (area surrounding both horn buds, both horn buds, muzzle, mucous membranes of the muzzle, both eyes) at nine time points (- 60 min (basal value), time of disbudding, 5, 30, 60, 90, 120, 240 and 480 min after disbudding) using a high-end thermographic camera (ThermoPro TP8, Firma DIAS Infrared GmbH). The rectal temperature was measured 60 min before and 5, 240 and 480 min after disbudding. The statistical software SAS version 9.4 was used for analysis. Skin surface temperatures and rectal temperature correlated at several locations (rp ≥ 0.45; p ≤ 0.05). The maximum temperature (approx. 67 ºC) was measured at the horn buds immediately after the hot-iron procedure. By five and 30 min after hot-iron disbudding, the temperature of the horn buds had decreased by up to 50%, whereas the temperatures at the other locations had increased significantly (p.
INTRODUCTION: Le but de cette étude était de montrer les températures de surface dans la zone de tête chez 28 veaux femelles Holstein allemandes autour de la période d'écornage en utilisant la thermographie. À cette fin, les animaux étudiés ont été divisés en deux groupes (1: écornage thermique (thermE), N = 14; 2: pseudo-écornage (ScheinE), N = 14). À neuf reprises (- 60 [valeur au repos], 0, 5, 30, 60, 90, 120, 240, 480 min) des mesures thermographiques ont été effectuées à huit endroits dans la zone de la tête (environs du bourgeon de corne gauche (UliHa), bourgeon de corne gauche (liHa), Åil gauche (liAu), mufle (FM), muqueuse nasale (SHFM), Åil droit (reAu), bourgeon de corne droite (reHa), environs du bourgeon de corne droit (UreHa)). Ces mesures ont été réalisés à l'aide d'une caméra d'imagerie thermique haut de gamme (ThermoPro TP8, société DIAS Infrared GmbH). De plus, la température interne du corps (ICT) a été enregistrée par voie rectale aux minutes - 60, 5, 240 et 480. L'évaluation statistique de chaque caractéristique a été effectuée avec SAS, version 9.4. À plusieurs endroits (reAu, liAu, SHFM, liHa), une relation entre les ICT mesurées par voie rectale et les températures de surface déterminées par thermographie a pu être démontrée (rp ≥ 0,45; p ≤ 0,05). La température maximale (env. 67 °C) a pu être constatée au niveau des bourgeons de corne directement après l'écornage thermique. Cinq et 30 minutes après l'intervention, la température au niveau des bourgeons de corne avait diminué jusqu'à 50%, tandis que les températures de surface des autres emplacements chez les veaux des deux groupes avaient augmenté par rapport à la valeur au repos (p.
Assuntos
Cornos/cirurgia , Temperatura Alta , Temperatura Cutânea , Termografia/veterinária , Animais , Temperatura Corporal , Bovinos , Feminino , Termografia/instrumentação , Termografia/normasRESUMO
BACKGROUND: Presence of good size perforators are mandatory to design perforator based pedicelledflaps specially in lower limb as flap failure rate isrelativelyhigh. We have explored the use ofsmartphonebaseddynamic thermal imagingand compared it with doppler to devise a protocol forplanning and executionof pedicled perforator flaps anddescribedits use in deciding delay of flap. We have also compared the time required for detecting dominant perforators. METHODS: This prospective case series was done atJinnah burn and reconstructive surgery center Lahore from July to September 2018and included patients requiring pedicled fasciocutaneous or musculocutaneous flapfor lower extremity reconstruction. Smartphonebased dynamic thermal imaging and doppler wereused to map out suitable perforators and confirmed intraoperatively. Comparison was made regarding their ability to locatedominant perforatorsandtotal time required.Utility of thermal imaging to ascertain flap perfusion postoperatively was also assessed.Flaps were designed according to thermal mapping. Clinical judgement supplemented with thermal imaging was usedto ascertain flap survival. RESULTS: The study included 15 patientsin which22 out 23 dominant perforators as located withthermal imaging were confirmed intra-operatively (positive predictive value = 95.7%) as compared to 22 out of 32 with doppler(positive predictive value=68.8%). Mean time required with doppler was 591.27±252.48, compared to 598.47±192.94 seconds with thermal imaging. In two cases flap was delayed. Partial flap necrosis occurred in one case. CONCLUSION: Dynamic thermal imaging can be reliably usedin planning of pedicled perforator flaps for lower limb reconstruction. We have found itmore reliable than handhelddoppler in locating dominant perforators.
Assuntos
Extremidade Inferior , Procedimentos de Cirurgia Plástica/métodos , Smartphone , Retalhos Cirúrgicos , Termografia/instrumentação , Humanos , Extremidade Inferior/diagnóstico por imagem , Extremidade Inferior/cirurgia , Valor Preditivo dos Testes , Estudos Prospectivos , Retalhos Cirúrgicos/irrigação sanguínea , Retalhos Cirúrgicos/cirurgia , Ultrassonografia DopplerRESUMO
The purposeof this study was to analyze skin temperature(Tsk)responses after a short-term maximum effort test in middle-distance runners.Aquasi-experimental study was conducted with ten men (age 23.5±5.10 years)who trained 5 days per week, 2 to 3 hours per day,and were submitted to thermographic evaluationbefore and after Cooper's 12-minute run test (CRT). The mean temperature of the anterior-superior,posterior-superior,anterior-inferior,and posterior-inferiorregionswas compared between the sides(i.e., left and right)before and after CRT.The paired t-testshowed asignificantdecrease in Tskafter CRT in thefollowingregions:right pectoralis major (-3.4%), left pectoralis major (-3.4%),and abdomen (-5%) in the anterior-superior view (p<0.01); and in the upper right trunk (-1.9%),upper lefttrunk(-1.9%) and lower back (-2.9%) in the posterior-superior view (p<0.05). In the lower limbs,asignificantincreaseintemperature of the left knee (1.6%),and right (3.6%) and left ankles (2.9%) in the anteriorview (p<0.05),as well as in theright (4.3%) and left ankles (3.7%) in the posteriorview (p<0.05)wereobserved. There was no difference in temperature between the right and left sides. In conclusion, the Tskchange of middle-distance runners wassymmetricalbetween sides,decreasing in upper limbs and trunk and increasing in lower limbs after a short-term maximum effort test.
Assuntos
Humanos , Masculino , Adulto , Corrida/fisiologia , Temperatura Cutânea/fisiologia , Atletas , Termografia/instrumentação , Extremidade Inferior/fisiologia , Extremidade Superior/fisiologia , Esforço Físico/fisiologiaRESUMO
Wallenberg's syndrome (WS) is a type of brainstem infarction. WS patients often show Horner's syndrome, dissociated sensory disturbance, truncal ataxia, and hoarseness. However, they rarely show tactile sensory disturbance and paralysis of the extremities. Additionally, acute brainstem infarction is often not apparent in magnetic resonance images. These symptomatic and imaging characteristics sometimes lead to misdiagnosis of WS as a non-stroke disease, including auditory vertigo. Although careful neurological examination is necessary to prevent misdiagnosis of WS, this type of examination may be difficult for non-neurologists to whom affected patients initially present. Lateral differences in body surface temperature (BST) constitute a recognized and widespread symptom of WS. We previously reported that most acute WS patients exhibit lateral differences in BST at multiple locations and that these lateral differences in BST could easily be detected by thermographic measurement. Here, we present the method for use of portable thermography to detect acute WS, using a simple, rapid, noninvasive, and cost-effective approach. To assess lateral differences in BST among patients with suspected WS, BST was measured as soon as possible in the examination room or in the patient's bedroom. Measurements were performed bilaterally at four locations where images could easily be acquired (face, palm of the hand, abdomen, and dorsum of the foot) using a portable thermal camera. When lateral differences in BST are observed macroscopically, especially in multiple locations on the same side, a diagnosis of WS should be suspected. Macroscopic assessment of BST laterality can be made within 2 min of the acquisition of thermographic images. This method may be useful in preventing misdiagnosis of acute WS as a non-stroke disease, especially when such patients initially present to non-neurologists.
Assuntos
Temperatura Corporal/fisiologia , Síndrome Medular Lateral/diagnóstico por imagem , Programas de Rastreamento/métodos , Termografia/métodos , Adulto , Feminino , Humanos , Síndrome Medular Lateral/fisiopatologia , Imageamento por Ressonância Magnética/instrumentação , Imageamento por Ressonância Magnética/métodos , Masculino , Programas de Rastreamento/instrumentação , Pessoa de Meia-Idade , Termografia/instrumentaçãoRESUMO
This article reviews the use of the smartphone in exotic pet medicine. The mobile app is the most instinctive use of the smartphone; however, there are very limited software dedicated to the exotic pet specifically. With an adapter, the smartphone can be attached to a regular endoscope and acts as a small endoscopic unit. Additional devices, such as infrared thermography or ultrasound, can be connected to the smartphone through the micro-USB port. The medical use of the smartphone is still in its infancy in veterinary medicine but can bring several solutions to the exotic pet practitioner and improve point-of-care evaluation.
Assuntos
Animais Exóticos , Aplicativos Móveis , Smartphone , Medicina Veterinária/instrumentação , Animais , Cardiologia/instrumentação , Cardiologia/métodos , Cardiologia/tendências , Endoscopia/instrumentação , Endoscopia/veterinária , Humanos , Raios Infravermelhos , Microscopia/instrumentação , Microscopia/métodos , Microscopia/tendências , Microscopia/veterinária , Aplicativos Móveis/normas , Aplicativos Móveis/tendências , Oftalmologia/instrumentação , Oftalmologia/métodos , Oftalmologia/tendências , Smartphone/tendências , Termografia/instrumentação , Termografia/métodos , Termografia/tendências , Termografia/veterinária , Ultrassonografia/instrumentação , Ultrassonografia/métodos , Ultrassonografia/tendências , Ultrassonografia/veterinária , Medicina Veterinária/métodos , Medicina Veterinária/tendênciasRESUMO
BACKGROUND: In microsurgical reconstruction, vascular obstruction occurs in approximately 20% of patients. Close monitoring is central to their care. Clinical/Doppler detection of vascular obstruction could be enhanced by thermography. METHODS: A diagnostic test design included consecutive cases of hospitalized patients, ≥18 years old, who underwent surgery with free flaps. Two researchers separately evaluated patients with clinical/Doppler methods and thermographic camera hourly for 24 hours, every 2 hours for the next 24 hours, and then every 3 hours until discharge. The gold standard was visualization of thrombus or vascular obstruction during surgical reintervention. Sensitivity, specificity, positive/negative predictive value (PPV/NPV), and a delta temperature receiver operating characteristic (ROC) curve were calculated. RESULTS: A total of 2,364 tests were performed with a thermographic camera in 40 patients (31 females, 9 males) aged 50.12 ± 9.7 years. There were 28 deep inferior epigastric perforator, 5 anterolateral thigh, 3 radial, 2 scapular, 1 fibular, and 1 anteromedial thigh flaps included. Six (15%) had postoperative vascular obstruction (5 venous and 1 arterial). One flap developed partial necrosis and one total necrosis (overall survival 97.5%). ROC curve (area 0.97) showed the best results at ≥ 1.8°C of difference to the surrounding skin. Considering two consecutive positive evaluations, the sensitivity was 93%, specificity 96%, PPV 57%, and NPV 99%. The thermal imaging camera allows to identify the obstruction between 2 and 12 hours before the clinical method. CONCLUSION: Utilizing a thermographic camera can reduce detection time of vascular obstruction by several hours in microvascular free flaps that include the cutaneous island. This method proves useful for early diagnosis of postoperative vascular obstruction.
Assuntos
Retalhos de Tecido Biológico/irrigação sanguínea , Oclusão de Enxerto Vascular/diagnóstico , Termografia/instrumentação , Diagnóstico Precoce , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e EspecificidadeRESUMO
Objetivo: Avaliar qualitativamente características do mapa termográfico do coto membro inferior íntegro e adaptação à prótese de pacientes amputados de membros inferiores. Método: Pesquisa qualitativa, do tipo descritiva e exploratória. Amostra foi composta por cinco indivíduos amputados de membros inferiores, de ambos os sexos, com os níveis transtibial e transfemural, idade entre 18 e 65 anos, alfabetizados e protetizados pelo Sistema Único de Saúde (SUS). Foi realizada anamnese e avaliação termográfica analisando qualitativamente o membro íntegro e coto aplicado o questionário Prothesis Evaluation Questionnaire (PEQ). Resultados: As imagens termográficas dos indivíduos transfemurais apresentaram no membro residual aumento da temperatura em região inguinal, podendo ser devido à fricção do encaixe superior da prótese. Em toda amostra percebeu-se diminuição da temperatura na extremidade inferior do coto, apontando uma possível redução de vascularização desta região. No PEQ o domínio fortemente mais citado como desfavorável para os participantes foi o de mobilidade, principalmente nas questões de subida e descida de escadas, subida e descida de morros íngremes e andar sobre lugares escorregadios. A transpiração dentro do encaixe e o inchaço do membro residual também foram queixas bem citadas pelos participantes. Conclusão: As questões de maior impacto à adaptação da prótese foram a mobilidade, transferência caraterísticas relacionadas ao edema, sensação de peso e desconforto térmico do membro residual na região do encaixe protético. A termografia evidenciou maiores valores de temperatura do membro íntegro, assim como aumento de temperatura na região do encaixe da prótese e redução de temperatura na extremidade do coto.
Objective: To evaluate qualitatively the characteristics of the thermographic map of the lower limb intact limb and adaptation to the prosthesis of amputated patients of lower limbs. Method: Qualitative research, descriptive and exploratory. The sample consisted of five amputees of lower limbs of both sexes, with transtibial and transfemoral levels, aged between 18 and 65 years, literate and protected by the Unified Health System (SUS). Anamnesis and thermographic evaluation were performed qualitatively analyzing the intact limb and stump applied to the Prothesis Evaluation Questionnaire (PEQ) questionnaire. Results: Thermographic images of transfemoral individuals presented in the residual limb an increase in temperature in the inguinal region, and may be due to the friction of the superior fit of the prosthesis. In all samples, temperature was observed in the lower extremity of the stump, indicating a possible reduction of vascularization in this region. In the PEQ, the domain most strongly cited as unfavorable for the participants was mobility, mainly in the questions of going up and down stairs, climbing and descending steep hills and walking on slippery places. The transpiration within the socket and the swelling of the residual limb were also complaints well cited by the participants. Conclusion: The issues of greatest impact to the adaptation of the prosthesis were the mobility, transfer characteristics related to the edema, sensation of weight and thermal discomfort of the residual limb in the region of the prosthetic fitting. Thermography showed higher values of intact limb temperature, as well as temperature increase in the prosthesis fitting region and temperature reduction at the end of the stump.
Assuntos
Humanos , Membros Artificiais , Termografia/instrumentação , Amputação Cirúrgica , Estudos de Avaliação como Assunto , Epidemiologia DescritivaRESUMO
The treatment of cancer by hyperthermia requires prediction, monitoring and control of the temperature within the tumor. Infrared thermography (IRT) was presented in this paper as a noninvasive temperature monitoring method used in magnetic nanoparticle hyperthermia (MNH). We tried to use this surface temperature measurement method to get information about the intratumoral temperature. Experimental in vitro MNH studies were performed on gel tumor-tissue phantoms which were constructed to simulate the real tumor and overlying healthy tissue. Magnetic nanoparticles were dispersed uniformly in the tumor part of phantom. During the process of in vitro MNH, an alternating magnetic field (AMF) was applied for heating, an IR thermal camera monitored the surface temperature and a fiber optical sensor measured the tumor temperature. A numerical finite element models of thermal analyses was built to simulate the MNH phantom experiments. Both experimental and numerical results indicate that the temperature difference between the surface hot spot and the tumor inner will reach a fixed value while the heating is going on. This value is correlated to factors such as heat generation of hyperthermia, size and depth of the tumor. A regression functions is established to describe the relationship, which is helpful for fast tumor inner temperature estimation by infrared thermography.
Assuntos
Hipertermia Induzida/métodos , Neoplasias/terapia , Termografia/instrumentação , Termografia/métodos , Raios Infravermelhos , Nanopartículas de Magnetita , Neoplasias/diagnóstico , Imagens de Fantasmas , TemperaturaRESUMO
BACKGROUND: Reliable detection of any circulatory issue threatening flap viability after free flap surgery is essential for prompt flap salvage. Currently, the gold standard of flap monitoring is clinical monitoring. However, this method presents logistical challenges to insufficient trained personnel. Auxiliary methods are becoming increasingly vital. MATERIALS AND METHODS: Twelve swine pedicle myocutaneous flaps were harvested and monitored using infrared cameras to investigate the developed monitoring parameters and vascular thrombosis in the free flap model. RESULTS: The mean flap surface temperature after vein or artery occlusion decreased significantly, but the differences were relatively small. As a result, the difference between recorded (flap surface temperature [Ts]) and predicted (estimated surface temperature [Tes]) flap surface temperature (ΔT = Ts- Tes) was used as the parameter for pedicle thrombosis. A ΔT of <0.86°C was used as a vascular occlusion criterion; the sensitivity and specificity of this parameter were 90% and 81%, respectively. The standard deviation of the surface temperature (SDT) was another indicator of vascular occlusion; the estimated sensitivity and specificity for vessel occlusion of SDT < 0.48°C were 84% and 73%, respectively. CONCLUSIONS: Infrared thermal imaging has the advantages of being noninvasive, contact-free, continuous, and able to detect the whole flap surface area. Two indicators, ΔT and SDT, can be used with high sensitivity and specificity for early prediction of flap pedicle thrombosis. Further human studies are necessary to validate clinical application of infrared thermal imaging.