Thermographic assessment of skin temperature after lumbar spine surgery: Useful method for detection of wound complications? A pilot study.

BACKGROUND: Wound complications after lumbar spine surgery may result in prolonged hospitalization and increased morbidity. Early identification can trigger appropriate management. OBJECTIVE: The aim of this study was to investigate the efficacy of infrared-based wound assessment (FLIR) after lumbar spine surgery in the context of identifying wound healing disorders. METHODS: 62 individuals who underwent lumbar spine surgery were included. The immediate postoperative course was studied, and the patient's sex, age, body mass index (BMI), heart rate, blood pressure, body temperature, numeric rating scale for pain (NRS), C-reactive protein (CRP), leukocyte, and hemoglobin levels were noted and compared to thermographic measurement of local surface temperature in the wound area. RESULTS: Measurement of local surface temperature in the wound area showed a consistent temperature distribution while it was uneven in case of wound healing disorder. In this instance, the region of the wound where the wound healing disorder occured had a lower temperature than the surrounding tissue (p> 0.05). CONCLUSIONS: This study demonstrates the ongoing importance of clinical wound assessment for early detection of complications. While laboratory parameter measurement is crucial, FLIR may serve as a cost-effective supplemental tool in clinical wound evaluation. Patient safety risks appear minimal since local ST is measured without touch.

Seasonal assessment of mastitis using thermogram analysis in murrah buffaloes.

Mastitis is a global threat that challenges dairy farmers' economies worldwide. Sub-clinical mastitis (SCM) beholds the lion's share in it, as its visible clinical signs are not evident and are challenging to diagnose. The treatment of intramammary infection (IMI) demands antimicrobial therapy and subsequent milk withdrawal for a week or two. This context requires a non-invasive diagnostic tool like infrared thermography (IRT) to identify mastitis. It can form the basis of precision dairy farming. Therefore, the present study focuses on thermal imaging of the udder and teat quarters of Murrah buffaloes during different seasons to identify SCM and clinical mastitis (CM) cases using the Darvi DTL007 camera. A total of 30-45 lactating Murrah buffalo cows were screened out using IRT regularly throughout the year 2021-22. The IMI was further screened using the California mastitis test. The thermogram analysis revealed a significant difference (p < 0.01) in the mean values of the udder and teat skin surface temperature of Murrah buffaloes between healthy, SCM, and CM during different seasons. The mean values of udder skin surface temperature (USST) during different seasons ranged between 30.28 and 36.81 °C, 32.54 to 38.61 °C, and 34.32 to 40.02 °C among healthy, SCM, and CM-affected quarters. Correspondingly, the mean values of teat skin surface temperature (TSST) were 30.52 to 35.96 °C, 32.92 to 37.55 °C, and 34.51 to 39.05 °C, respectively. Further results revealed an increase (p < 0.01) in the mean values of USST during winter, summer, rainy, and autumn as 2.26, 4.04; 2.19, 3.35; 1.80, 3.21; and 1.45, 2.64 °C and TSST as 2.40, 3.99; 2.28, 3.26; 1.59, 3.09; and 1.68, 2.92 °C of SCM, CM-affected quarters to healthy quarters, respectively. The highest incidence of SCM was observed during autumn and CM during winter. Henceforth, irrespective of the seasons studied in the present study, IRT is an efficient, supportive tool for the early identification of SCM.

Energy expenditure and physiological markers during a city mountain hike in the heat: A case study.

Background: Energy expenditure may be difficult to assess when hiking difficult trails. Case presentation: We measured physical activity exercise energy expenditure (PAEE) directly from oxygen uptake using a mobile device (cardiopulmonary exercise testing, CPET), and by using a formula based on heart rate (HR), or metabolic equivalent values from the Compendium of Physical Activity, and other physiological outcomes. Outcomes and implications: Total PAEE (1342 kcal) using CPET showed a two-fold difference between ascending and descending (887 vs. 455 kcal) during a 124-min hike. For HR, PAEE was 1893kcal (+551 kcal overreporting), while compendium-based scenarios ranged from 1179 to 1446 kcal, which was in closer range (-163 to +104 kcal/min) compared to the CPET data. Fluid consumption was 1300 mL/hour, with 1.1% bodyweight loss, peak skin temperature of 35.2°C and core body temperature of 39.2°C. Recommendations: Tables reasonably predict energy expenditure while not precisely reflecting the actual situation.

Cost-effectiveness of temperature monitoring to help prevent foot ulcer recurrence in people with diabetes: A multicenter randomized controlled trial.

AIMS: Diabetes-related foot ulcers are common, costly, and frequently recur. Multiple interventions help prevent these ulcers. However, none of these have been prospectively investigated for cost-effectiveness. Our aim was to evaluate the cost-effectiveness of at-home skin temperature monitoring to help prevent diabetes-related foot ulcer recurrence. MATERIALS AND METHODS: Multicenter randomized controlled trial. We randomized 304 persons at high diabetes-related foot ulcer risk to either usual foot care plus daily at-home foot skin temperature monitoring (intervention) or usual care alone (control). Primary outcome was cost-effectiveness based on foot care costs and quality-adjusted life years (QALY) during 18 months follow-up. Foot care costs included costs for ulcer prevention (e.g., footwear, podiatry) and for ulcer treatment when required (e.g., consultation, hospitalisation, amputation). Incremental cost-effectiveness ratios were calculated for intervention versus usual care using probabilistic sensitivity analysis for willingness-to-pay/accept levels up to €100,000. RESULTS: The intervention had a 45% probability of being cost-effective at a willingness-to-accept of €50,000 per QALY lost. This resulted from (non-significantly) lower foot care costs in the intervention group (€6067 vs. €7376; p = 0.45) because of (significantly) fewer participants with ulcer recurrence(s) in 18 months (36% vs. 47%; p = 0.045); however, QALYs were (non-significantly) lower in the intervention group (1.09 vs. 1.12; p = 0.35), especially in those without foot ulcer recurrence (1.09 vs. 1.17; p = 0.10). CONCLUSIONS: At-home skin temperature monitoring for diabetes-related foot ulcer prevention compared with usual care is at best equally cost-effective. The intervention resulted in cost-savings due to preventing foot ulcer recurrence and related costs, but this came at the expense of QALY loss, potentially from self-monitoring burdens.

Equivalent contact temperature (ECT) for personal comfort assessment - analytical description and definition of comfort limits.

This paper introduces the equivalent contact temperature (ECT) model for local thermal comfort assessment in contact areas for non-uniform environmental conditions. It aims to complete the comfort evaluation scheme of the equivalent temperature approach included in ISO 14505-2 by the contact areas back and buttocks that are currently neglected in the standard. For the assessment of local and overall thermal comfort of seated persons, these contact areas are of great importance, especially if exposed to personal comfort systems. Person-oriented climatization systems, such as seat heating and ventilation, are much more energy efficient than conventional HVAC systems and allow to incorporate the human individual into the system's control loop. The ECT-approach is formally defined, analytically as well as mathematically derived and validated by a subject study. The results of the subject study (air temperature of 26 °C and 29 °C) confirm the cooling effect due to the seat ventilation and show fundamental correlations between ECTs and body part specific mean thermal votes for buttocks and back.Practitioner summary:The equivalent contact temperature model for local thermal comfort assessment in contact areas for non-uniform environmental conditions is formally defined, analytically as well as mathematically derived and validated by a subject study. It completes the existing equivalent temperature comfort scheme by both contact areas back a nd buttocks to improve thermal comfort assessment.

Directional assessment of the skin barrier function in vivo.

INTRODUCTION: The fundamental function of the epidermis is to provide an inside-out barrier to water loss and an outside-in barrier to penetration of external irritants. Transepidermal water loss (TEWL) has been extensively used as a method of estimating the skin barrier quality, typically without any consideration of directionality. The validity of TEWL as an estimate of skin permeability to external substances has been controversial in vitro and in vivo. The aim of this work was to assess the relationship between TEWL and the penetration of a topically applied external marker (caffeine) in healthy skin in vivo before and following a challenge to the barrier. METHODS: The skin barrier was challenged by application of aqueous solutions of mild cleanser products under occlusion for 3 h on the forearms of nine human participants. Skin barrier quality was evaluated before and after the challenge by measuring the TEWL rate and the permeated amount of topically applied caffeine using in vivo confocal Raman microspectroscopy. RESULTS: No skin irritation was observed following the skin barrier challenge. TEWL rates and the caffeine penetrated amount in the stratum corneum after the challenge were not correlated. A weak correlation was observed when the changes were corrected to water-only treatment. TEWL values can be influenced by environmental conditions as well as the skin temperature and water content. CONCLUSIONS: Measuring TEWL rates is not always representative of the outside-in barrier. TEWL may be useful in differentiating large changes in skin barrier function (e.g., between healthy and compromised skin) but is less sensitive to small variations following topical application of mild cleansers.

Preliminary assessment of the reliability and validity of infrared skin temperature measurements in Rett syndrome.

BACKGROUND: As clinical trials for Rett syndrome are underway, there is a need to validate potential supplemental outcome measures that reflect important signs and symptoms. Autonomic dysfunction, particularly vasomotor dysfunction, is one potential area for which biomarkers could be developed. METHODS: In the current study, infrared thermal images of hands and feet from 26 females with Rett syndrome (aged 62 months to 39 years), and 17 females without known intellectual, genetic or neurological disorders (aged 55 months to 39 years) were collected. Between-group differences in skin temperature, and temporal stability of skin temperature measures in the Rett syndrome group, and relationships between skin temperature measures and parent-reported and researcher-evaluated indicators of autonomic dysfunction were evaluated. RESULTS: Between-group differences showed lower hand and foot temperatures in the Rett syndrome group. Hand temperature measurements were stable over time and were moderately correlated with parent-reported autonomic symptoms. Foot temperature measurements were more variable than hand temperatures but showed stronger correlations with parent-reported autonomic symptoms. CONCLUSIONS: The results provide preliminary support for the reliability and validity of hand and foot skin temperature measures in Rett syndrome. Additional research is needed to replicate these results and evaluate the temporal stability of these measures over shorter time scales.

The Use of Infrared Thermography in the Assessment of Thermal Reaction of Patients Treated with Radiotherapy after Breast-Conserving Procedures.

The aim of the study was to assess the usefulness of the infrared thermography method in the assessment of the body's thermal reaction in patients during radiotherapy. Studies have shown how the temperature distribution changes with the dose of radiation used in each treatment week. Fifty-four patients participated in the study. The control group consisted of healthy patients, among whom the difference in mean temperatures between the breasts was checked. The study group included patients after conserving procedures qualified for radiotherapy. Measurements were taken and analyzed for each patient during each week of treatment. The target area (marked by a doctor) and the 30 Gy, 20 Gy and 10 Gy isodoses (generated from the treatment plan) were transferred on thermograms and then analyzed. This way of defining the observed areas is the most accurate and individually adjusted to each treated patient. The analysis showed an increase in temperature in the tested body surface areas, whereas the highest average temperature value was achieved during the third week of treatment. The observations may be used to evaluate the skin reaction from radiation; however, they require further studies and new quantitative parameters.

NEURO TOUCH: A novel digital device for assessment and screening of peripheral neuropathy.

BACKGROUND: Most of the patients suffering from diabetes develop Sensory neuropathy which proceeds with development of painful neuropathy. This can lead to formation of ulcers in later stages. Currently, available Quantitative Sensory Testing (QST) devices take more time to perform and are expensive. NEURO TOUCH is such device which combines four parameters of QST in one unit. Its portable, battery operated and handy device with real time display of results along with data storage and data transfer facility. It can perform tactile sensation threshold, vibration and thermal testing threshold along with skin temperature measurement. This study was undertaken to establish the diagnostic validity, reproducibility and repeatability for early detection of peripheral neuropathy. METHODS: A total of 317 subjects were recruited for QST assessment with NEURO TOUCH; Tactile threshold sensation, vibration perception and thermal threshold testing along with skin temperature. A subset of 30 subjects in each group were considered for repeatability and reproducibility test. RESULTS: The mean difference for vibration perception threshold was 0.6 when compared with gold standard device. Regarding the cold and warm perception threshold the mean difference was 1.1 and 2 °C respectively when compared with gold standard device. For skin temperature measures there was a mean difference of 1.2 °C with respect to standard device. CONCLUSIONS: The NEURO TOUCH device was easy-to-use, compact and provided an efficient multimodality approach which can help for screening of peripheral neuropathy patients with type 2 diabetes.

Clothing Insulation Rate and Metabolic Rate Estimation for Individual Thermal Comfort Assessment in Real Life.

Satisfactory indoor thermal environments can improve working efficiencies of office staff. To build such satisfactory indoor microclimates, individual thermal comfort assessment is important, for which personal clothing insulation rate (Icl) and metabolic rate (M) need to be estimated dynamically. Therefore, this paper proposes a vision-based method. Specifically, a human tracking-by-detection framework is implemented to acquire each person's clothing status (short-sleeved, long-sleeved), key posture (sitting, standing), and bounding box information simultaneously. The clothing status together with a key body points detector locate the person's skin region and clothes region, allowing the measurement of skin temperature (Ts) and clothes temperature (Tc), and realizing the calculation of Icl from Ts and Tc. The key posture and the bounding box change across time can category the person's activity intensity into a corresponding level, from which the M value is estimated. Moreover, we have collected a multi-person thermal dataset to evaluate the method. The tracking-by-detection framework achieves a mAP50 (Mean Average Precision) rate of 89.1% and a MOTA (Multiple Object Tracking Accuracy) rate of 99.5%. The Icl estimation module gets an accuracy of 96.2% in locating skin and clothes. The M estimation module obtains a classification rate of 95.6% in categorizing activity level. All of these prove the usefulness of the proposed method in a multi-person scenario of real-life applications.

Cold arousal - A mechanism used by hibernating bats to reduce the energetic costs of disturbance.

During the season of hibernation, temperate bats alternate between prolonged bouts of torpor with reduced body temperature and short arousals with a return to normothermy. Hibernating bats are sensitive to non-tactile stimuli and arouse following changes in microclimatic conditions or disturbance from other bats, potential predators, or humans. Here, we used temperature data loggers to register the skin temperature of 38 Myotis myotis bats over two winters (between January and March), during which regular visits were made to the hibernaculum. Two kinds of arousal were observed, normothermic (Tsk > 25 °C) and cold (Tsk < 15 °C). Although bats responded to the presence of a researcher by arousals of both kinds, cold arousals were more frequent (63.8%). We found that mass loss was not affected by the number of disturbances, however it was in positive relationship with the mass at the beginning of the observation and differed between sex and age categories. Furthermore normothermic bats crawling among cluster-mates initiated arousal cascades, which mainly consisted of cold arousals. We failed to detect any effect of age or sex on the number of arousals initiated by normothermic individuals. Warming by only a few degrees requires less energy than a normothermic arousal and we propose it is sufficient to activate the sensory system in order to assess the relevance of external stimuli. Our results indicate that cold arousals reflect a physiological and behavioural adaptation aimed at avoiding the energetic costs of disturbance that can lead to depletion of fat reserves.

Skin Temperature Assessment During Lumbar Sympathetic Blocks by Infrared Thermography.

Complex Regional Pain Syndrome (CRPS) is a pain disorder that can be triggered by injuries or surgery affecting most often limbs. Its multifaceted pathophysiology makes its diagnosis and treatment a challenging work. To reduce pain, patients diagnosed with CRPS commonly undergo sympathetic blocks which involves the injection of a local anesthetic drug around the nerves. Currently, this procedure is guided by fluoroscopy which occasionally is considered as little accurate. For this reason, the use of infrared thermography as a technique of support has been considered.In this work, thermal images of feet soles in patients with lower limbs CRPS undergoing lumbar sympathetic blocks were recorded and evaluated. The images were analyzed by means of a computer-aided intuitive software tool developed using MATLAB. This tool provides the possibility of editing regions of interest, extracting the most important information of these regions and exporting the results data to an Excel file.Clinical Relevance- The final purpose of this work is to value the potential of infrared thermography and the analysis of its images as an intraoperatory technique of support in lumbar sympathetic blocks in patients with lower limbs CRPS.

Reliability of Low-Cost Thermometers for Monitoring Foot Temperature.

The prevalence of diabetes in the United States and the world is high. Often the burden of this disease falls on those who are economically disadvantaged, contributing to disparities in access to care. Considering the risk for foot complications related to diabetes, foot temperature monitoring has been shown to be effective in mitigating risk for plantar ulceration. Higher-cost thermometers have been assessed for reliability, while very low-cost thermometers have not. Validation of low-cost thermometers could improve access to this preventive measure. In this study, inexpensive commercially available infrared thermometers were shown to be a reliable and valid means to assess local skin temperature.

Human thermophysiological models: Quantification of uncertainty in the output quantities of the passive system due to uncertainties in the control equations of the active system via the Monte Carlo method.

Uncertainty propagation analysis in the Fiala thermophysiological model is performed by the Monte Carlo Method. The uncertainties of the output quantities of the passive system, due to imported uncertainties in the coefficients of the control equations of the active system, caused by the variation of the experimental data, are computed. The developed and implemented in-house code is accordingly validated. The effect of the input uncertainties, in each of the four main responses (shivering, vasodilatation, vasoconstriction, sweating) of the active system, is separately examined by simulating the human exposure from neutral conditions to cold and hot environments. It is predicted that the maximum output uncertainties of the response mechanisms may be of the same order of magnitude as the imported ones, while the corresponding maximum uncertainties in core and skin temperatures always remain less than 2%. The maximum absolute deviations of the rectal (core) temperatures from their estimated mean values may be up to 0.72 °C and 0.22 °C, due to input uncertainties in shivering and sweating respectively, while the corresponding deviations due to uncertainties in vasomotion processes are negligible. The deviations, particularly the ones due to shivering, are significant, since differences of a few tenths of a degree may have large impact in human health. The maximum absolute deviations of the skin temperatures are 0.42 °C in the hands due to uncertainties in shivering and 0.69 °C in the feet due to uncertainties in vasodilatation. These deviations are less significant than the core ones, but they may still affect human thermal sensation and comfort. The present analysis provides a better insight in the dynamic response of the model and indicates which response mechanism needs to be further investigated by more accurate estimates in order to improve model reliability. It can be also applied in other human thermophysiological models.

Quantitative assessment of Bell's palsy-related facial thermal asymmetry using infrared thermography: A preliminary study.

The temperature distribution of normal human skin is symmetrical. Facial paralysis generally changes this thermal symmetry. The aim of this study is to analyze facial thermal asymmetry during the early onset of Bell's palsy, and to assess the feasibility of the diagnosis of early-onset Bell's palsy using infrared thermography (IRT). Fifteen subjects with Bell's palsy and 15 healthy volunteers were considered in this study. The infrared thermal images of the front, left, and right sides of all the subjects were collected and analyzed. Each group of facial thermograms was divided into 16 symmetrical regions of interest (ROIs) with respect to the left and right sides. Three different temperature difference calculation methods were used to express the degree of thermal symmetry between the left- and right-side ROIs, namely, the mean temperature difference (ΔTroi), maximum temperature difference (ΔTmax), and minimum temperature difference (ΔTmin). Among the facial ROIs, there were significant differences in the thermal symmetries of the frontal region, medial canthus region, and infraorbital region between subjects with and without Bell's palsy (p < 0.05). Based on the results, ΔTroi was more effective than the other two methods for the diagnosis of early-onset Bell's palsy. The area under the ROC curve (AUC) of ΔTroi in the infraorbital region was 0.818; and the sensitivity and specificity were 0.867 and 0.800, respectively. Subjects with early-onset Bell's palsy exhibited thermal asymmetry on the left and right sides of their faces. The diagnosis of early-onset Bell's palsy using IRT is therefore necessary. Nevertheless, more effective thermal symmetry analysis methods will be investigated further in future research.

Assessment of the Dynamics of Temperature Changes in the Knee Joint Area in Response to Selected Cooling Agents in Thermographic Tests.

Although local cryotherapy (LC) is performed with various cooling agents (CAg) such as ice, water, and gasses, in clinical practice, it is mostly performed with cooling gasses. Presently, LC with cooling gasses is very popular but the inference about the thermal (stimulus) effect on the tissues is mainly based on research carried out using ice packs. The proposed objective of the study was to evaluate the dynamics of temperature changes in the knee joint area in response to a 3-min exposure to liquid nitrogen vapors (LNVs), cold air (CA) and ice bag (IB). The study group included 23 healthy volunteers with an average age of 26.67 ± 4.56. The exposed (ROIE) and contralateral (ROINE) areas of the knee joint after exposure to CAg were observed. Immediately after 3 min of LC, the ROIE temperature dropped by 10.11 ± 0.91 °C after LNV, 7.59 ± 0.14 °C after IB and 6.76 ± 1.3 °C after CA. Significant tissue cooling was maintained up to 15 min after LNV (p < 0.01), 10 min after IB (p < 0.05) and 5 min after CA (p < 0.05). LC causes significant temperature changes both in ROIE and ROINE. The greatest cooling potential was demonstrated for LNV and the lowest for CA.

Application of a novel finger temperature device in the assessment of subjects with Raynaud's phenomenon.

INTRODUCTION: Finger skin thermometry is one of the most commonly used methods for evaluating the response of the digital vessels to cold stimulation. The aim of this study was to evaluate the applicability of a novel finger skin temperature device for performing cold-stimulation test (CST) in subjects with primary and secondary Raynaud's phenomenon (RP). METHODOLOGY: A total of 155 consecutive subjects were studied. They were divided into three groups: 73 patients with primary RP (8 males, 65 females, mean age 38.5 ± 16.2), 42 patients with secondary RP (4 males, 38 females, mean age 49.6 ± 13.1, connected with lupus erythematosus and systemic scleroderma), and 40 healthy controls (5 males, 35 females, mean age 38.8 ± 16.6). Standardized CST consisting of exposure of both hands to water with a temperature of 10℃ for 5 minutes was performed. Changes in skin temperature of both wrists and 2-5 fingers were measured using a novel finger temperature device (Courage & Khazaka). Measurements were made before and 5, 10, 15, 20, 25, and 30 minutes after cold stimulation. The time of recovery for baseline temperature of all fingers below 15 minutes was considered normal. RESULTS: The CST was normal in 6 (8.2%) of the patients with primary RP, in 7 (16.6%) of the patients with secondary RP, and in 28 (70%) of the healthy control subjects. The time of complete recovery of baseline temperature with respect to the first finger and for all 2-5 fingers in the three groups was as follows: 24.8 and 28.5 minutes (primary RP), 21.7 and 26.8 minutes (secondary RP), and 11.1 and 15.2 minutes (healthy subjects). Furthermore, the microcirculation was seriously disturbed (rewarming time >31 minutes of all 2-5 digits of both hands) in 54.1% (n = 79), 34.5% (n = 29) and 5% (n = 4) in the same study groups. DISCUSSION: Our results suggested that skin microcirculation is more disturbed in patients with primary RP than in patients with secondary RP. In support of this unexpected finding were the results reported by Ruaro B. et al (2019). They investigated the blood perfusion (BP) by laser speckle contrast analysis (LASCA) at different skin areas of hands and found that it was significantly lower in primary RP than in secondary RP related to systemic sclerosis. CONCLUSION: The new finger temperature device used could be considered useful for performing cold-stimulation test in patients with Raynaud's phenomenon.

Thermal imaging ruled out as a supplementary assessment in patients with fibromyalgia: A cross-sectional study.

BACKGROUND: The diagnosis of fibromyalgia syndrome (FMS) syndrome is often complicated and relies on diagnostic criteria based mostly on the symptoms reported by patients. Implementing objective complementary tests would be desirable to better characterize this population. OBJECTIVE: The purpose of this cross-sectional study was to compare the skin temperature at rest using thermography in women with FMS and healthy women. METHODS: Eighty-six women with FMS and 92 healthy controls volunteered to participate. The temperature of all participants was measured by infra-red thermography, registering the skin surface temperature (minimum, maximum and average) at rest in different areas: neck, upper and lower back, chest, knees and elbows. In order to analyze the differences in the skin temperature between groups, inferential analyses of the data were performed using Mann-Whitney U test. RESULTS: The results showed no significant difference in skin temperature between groups in the neck, upper back, chest and elbows (p>0.05). The lower back and knees areas showed significant differences between groups (p<0.05), although these differences did not reach a minimum of clinically detectable change. CONCLUSIONS: Women with fibromyalgia presented no clinically meaningful reduction or difference in skin temperature at rest when compared with a group of healthy women. The infra-red thermography is not an effective supplementary assessment tool in women with fibromyalgia.