Physical properties of Scarpa's fascia.

Preservation of Scarpa's fascia has improved clinical outcomes in abdominoplasty procedures and in other body contour surgeries. However, the physical properties of Scarpa's fascia have not yet been described, and grafts are still underexplored. Fresh surgical specimens from five female patients subjected to classical abdominoplasty were dissected and analyzed. A grid was drawn on the fascia surface, dividing it into equal upper and lower halves; four Scarpa's fascia samples (30 × 10 mm) were collected from each half, 40 mm apart. The thickness was measured with a caliper. A strain/stress universal testing machine was used for mechanical tests. Twenty-five samples were obtained (nine from the upper half, 16 from the lower). The average thickness was 0.56 ± 0.11 mm. The average values for stretch, stress, strain, and Young's Modulus were, respectively, 1.436, 4.198 MPa, 43.6%, and 23.14 MPa. The upper half showed significantly greater thickness and strain values (p = 0.020 and p = 0.048; Student's t-test). The physical and biomechanical properties of Scarpa's fascia can make it a donor area for fascial grafts as an alternative to fascia lata, as it is always available and has minimal donor-site morbidity. Further studies are needed to validate this statement. It seems advantageous to use the lower half of the abdomen instead of the upper part as a donor site.

Pre-exercise skin temperature evolution is not related with 100 m front crawl performance.

During the transition between warm-up and competition there is a change in core, muscle and (eventually) skin temperature that may affect swimming performance. We have aimed to assess skin temperature evolution during transition phases of different durations before a typical front crawl effort and to investigate its relationship with performance. Following a standardized warm-up, nine adolescent male swimmers performed three maximal randomized 100 m maximum front crawl trials after 10, 20 and 45 min transition phases. Skin temperature, performance (time, stroke frequency, length and index, and propelling efficiency), heart rate, lactate and perceived effort were assessed. Data showed a skin temperature log increase over time (R2 > 0.96, p < 0.01) without differences from the 15 min with the following instants. Performance and psychophysiological variables were similar between transition phases. However, skin temperature at the end of the transition periods, i.e., just before the 100 m trials, was lower in the 10 min than the 20 and 45 min transitions (32.0 ± 0.6 vs 33.0 ± 0.4 and 33.5 ± 0.5 °C, respectively). The main finding was that no relevant relationships were observed between pre-test skin temperature and performance times (|r| < 0.6, p > 0.05) for the studied transition phases. We have concluded that transitions longer than 10 min will not present thermal changes and that, within the physiologic limits studied, pre-exercise skin temperature does not influence swimming performance.

Infrared thermography of the crânio-cervico-mandibular complex in wind and string instrumentalists.

PURPOSE: Musculoskeletal disorders can be common in wind and string instrumentalists. The musical gesture technique associated to musical performance can promote an asymmetrical isometric contraction with the hyperactivity of specific muscular groups and the overload of articular surfaces which can cause discomfort or pain. The aim of this investigation was to assess specific anatomical regions of interest within the cranio-cervico-mandibular complex in order to determine and evaluate the presence of muscular hyperactivity associated to musical performance. METHODS: An infrared imaging camera, FLIR®, was used to record the regions of interest in wind (n = 48) and string instrumentalists (n = 29). Bilateral temperature differences were considered as thermal asymmetries with a conventional threshold of 0.3 ºC to distinguish pathological from healthy states. The regions of interest (ROI) were the anterior triangle of the neck, the sternocleidomastoid and trapezius muscles regarding the postural and stabilizing muscles of the head and neck. On the orofacial region, the anatomical sites were the anterior temporal muscle, the masseter muscle and the temporomandibular joint. A Pearson chi-square test was performed to compare the assessed areas. RESULTS: Between 30-37% of all participants showed ROI in an asymmetric pattern. The most affected sites were the temporal muscle and the TMJ for both groups. The anterior triangle of the neck showed statistical differences (p = 0.044) between string and wind instrumentalists, while the temporal (p = 0.034) and trapezius muscle (p = 0.028) when comparing large and small mouthpieces of brass instruments. Although female participants showed a higher prevalence of asymmetrical patterns regarding the ROI, no statistical differences were found between genders. CONCLUSIONS: Infrared thermography exhibited significant differences between wind and string instruments within the CCMC. Regarding the issue of occupational health in performing arts, it is an advantage being able to quantify asymmetrical patterns sites of the CCMC to understand the underlying physiological responses to repetitive movements, overloading and muscular hyperactivity that occur during musical performance.

The role of AI classifiers in skin cancer images.

BACKGROUND: The use of different imaging modalities to assist in skin cancer diagnosis is a common practice in clinical scenarios. Different features representative of the lesion under evaluation can be retrieved from image analysis and processing. However, the integration and understanding of these additional parameters can be a challenging task for physicians, so artificial intelligence (AI) methods can be implemented to assist in this process. This bibliographic research was performed with the goal of assessing the current applications of AI algorithms as an assistive tool in skin cancer diagnosis, based on information retrieved from different imaging modalities. MATERIALS AND METHODS: The bibliography databases ISI Web of Science, PubMed and Scopus were used for the literature search, with the combination of keywords: skin cancer, skin neoplasm, imaging and classification methods. RESULTS: The search resulted in 526 publications, which underwent a screening process, considering the established eligibility criteria. After screening, only 65 were qualified for revision. CONCLUSION: Different imaging modalities have already been coupled with AI methods, particularly dermoscopy for melanoma recognition. Learners based on support vector machines seem to be the preferred option. Future work should focus on image analysis, processing stages and image fusion assuring the best possible classification outcome.

Biomedical musculoskeletal applications of infrared thermal imaging on arm and forearm: A systematic review.

Infrared thermal imaging (IRT) has been a target of research for biomedical musculoskeletal applications, due to the possible association of the physiological data that it provides, through skin temperature measurement, with pathological states. The aim of this systematic review is to acquaint the outcomes of the biomedical application of IRT in arm and forearm evaluation and its future perspectives of research. During the literature review, 926 articles were identified using the search engines PubMed and Scopus, and 10 articles were retrieved from other sources. After screening the abstracts and applying the eligibility criteria on those which were fully accessible, 33 articles were included in the review. It can be observed that IRT has the potential to provide physiological information on the arm and forearm, showing potential to serve as an aid in various pathologies and health situations. Future studies and challenges are identified and proposed, facilitating the improvement and acceptance of the application of IRT in the assessment of arm and forearm' health status.

Are there any solutions for improving the cleft area hygiene in patients with cleft lip and palate? A systematic review.

OBJECTIVE: Children with cleft lip and palate (CLP) present high incidence of oral health problems, namely those associated with the accumulation of dental plaque. The objective of this systematic review was to verify if there is any solution to improve the hygiene of the cleft area. MATERIALS AND METHODS: A structured systematic review was performed based on articles published in several electronic databases: PubMed, Web of Science, Cochrane Library and Scopus in the last 20 years. The MeSH terms used were cleft lip, palate, harelip, oral hygiene and toothbrush. RESULTS: From 270 potentially relevant articles, 39 articles were selected, corresponding to a total of 3226 CLP patients and 914 matched controls. The selected studies exhibited great heterogeneity regarding the type of the study, study population (average range 0 -49 years old; sampling sizes 15-400 CLP patients), evaluation periods, reported variables and oral hygiene routines. Consensual outcomes were the presence of high plaque indexes, high prevalence of dental caries and worse oral hygiene patterns in CLP patients. Additionally, poor education in oral health and low motivation to integrate regular hygiene routines in the daily family life were also evident. CONCLUSION: There is a clear need to improve the oral hygiene care of CLP children, but few studies were focused on specific preventive approaches. Development of devices especially designed to the hygiene of the cleft area and implementation of standardized prevention and control programmes targeting education, motivation and compliance would contribute to improve oral health in CLP children.

Antero-cervical thermophysiological characterization of obstructive sleep apnea patients.

PURPOSE: Obstructive sleep apnea syndrome (OSAS) is characterized by upper airway inflammation. The aim of this study was to characterize thermal profile of the antero-cervical region in OSAS patients through medical thermal imaging and to compare the respective subjects with non-OSAS individuals. METHODS: Image capture followed the Glamorgan Protocol. A dynamic thermographic examination of the anterior cervical region (at baseline and after a cold stimulus) was conducted in 26 patients diagnosed with overnight polysomnography (PSG). PSG results stratified the subjects into OSAS and non-OSAS groups and their thermograms were compared. RESULTS: Eleven non-OSAS and 15 OSAS subjects were evaluated. Antero-cervical right side (RS) temperature was higher in OSAS group at baseline (p = 0.014). Right side index (RSI) temperature-the difference between RS and submental region, considered as control-was lower in OSAS subjects at baseline (p = 0.020) and 10 min after the cold stimuli was applied (p = 0.008), indicating higher absolute temperatures in this group. Left side index (LSI) was also lower at 10 min in OSAS group (p = 0.021). Statistical correlation was found between apnea-hypopnea index and RS at baseline (r = 0.424, p = 0.031) and at 10 min (r = 0.403, p = 0.041) and RSI at baseline (r = - 0.458, p = 0.019) and 10 min after cold provocation was applied (r = - 0.435, p = 0.025). CONCLUSIONS: OSAS patients have shown higher antero-cervical temperatures compared with non-OSAS counterparts and temperature was associated with severity of the condition. Medical thermography may be a suitable tool in the setting of OSAS suspicion.

Combined Acquisition Method of Image and Signal Technique (CAMIST) for Assessment of Temporomandibular Disorders in Performing Arts Medicine.

OBJECTIVE: This pilot study investigated the morphological and functional aspects of an English horn player, who presented at a dental appointment with temporomandibular disorder (TMD), using the "combined acquisition method of image and signal technique" (CAMIST) in the diagnosis. METHODS: Cephalometric analysis was obtained after carrying out three lateral cephalograms using a standardized radiographic technique. The first one was taken with the teeth in the normal occlusion and the lips relaxed, the second with the oboe embouchure, and the last was performed with the English horn. To understand the pressures involved during the embouchure and musical performance of the English horn and oboe, a system was developed using force sensors placed on the double-reed mouthpiece. Finally, infrared imaging was used to better understand the anatomy-physiology of specific structures of the cranio-cervico-mandibular complex. RESULTS: Cephalometry of the musician showed more significant changes in the retrusion of the mandibular pogonion. The embouchure pressures measured during musical practice showed that the English horn induced a higher pressure on the lower lip than on the upper, while the inverse happened with the oboe. Thermography confirmed the painful site on the left temporomandibular joint (TMJ), and this was also observed in the muscle tenderness/discomfort on the right superficial masseter by the differential temperature of these areas. CONCLUSION: Techniques such as lateral teleradiography, infrared imaging, and force sensors can be useful screening tools with added value for the diagnosis of TMDs in performing artists.

Classic Versus Scarpa-sparing abdominoplasty: An infrared thermographic comparative analysis.

BACKGROUND: Scarpa fascia preservation during abdominoplasty has been shown to have several clinical advantages. The mechanisms behind its efficiency have been the subject of several studies. Three theories have been proposed, relating to mechanical factors, lymphatic preservation, and improved vascularization. This study aimed to further investigate the possible vascular impact of Scarpa fascia preservation by using a thermographic analysis. METHODS: A single-center prospective study was conducted, involving 12 female patients randomly and equally assigned to one of two surgical procedures: classic (Group A) and Scarpa-sparing abdominoplasty (Group B). Dynamic thermography was applied before and after surgery (one and six months), and two regions of interest (ROIs) were considered. The latter had the same location on every sample, and corresponded to areas where different surgical planes had been used. Static thermography was applied intraoperatively, and four ROIs were considered, located over Scarpa and over the deep fascia. The respective thermal data were analyzed. RESULTS: The general characteristics of both groups were identical. Preoperative thermography demonstrated no differences between groups. Intraoperative higher thermal gradients between lateral and medial ROIs were observed in Group B (P = 0.037, right side). Dynamic thermography at one month demonstrated a trend for better thermal recovery and better thermal symmetry (P = 0.035, 1-min mark) in Group B. No other differences were found. CONCLUSION: Dynamic thermography presented a better response when Scarpa fascia was preserved: stronger, faster, and more symmetric. Based on these results, improved vascularization may have a role in explaining the clinical efficiency of a Scarpa-sparing abdominoplasty.

Use of Infrared Thermography for Abdominoplasty Procedures in Patients with Extensive Subcostal Scars: A Preliminary Analysis.

Subcostal scars may increase the risk of healing complications in abdominoplasty. The authors evaluated the use of thermography as a potential tool for patient selection and surgery planning to avoid complications and improve abdominoplasty outcomes. Two candidates for abdominoplasty procedures who presented with extensive subcostal scars were submitted to an infrared thermography protocol at all phases of the procedure: preoperative, intraoperative, and postoperative at 1 and 6 months. The preoperative thermography for both patients revealed near-normal abdominal wall perfusion. The thermograms captured intraoperatively during flap elevation did not show perfusion deficits on the upper abdominal flap. At 1 month and 6 months postoperative, dynamic thermography for both patients showed normal to near-normal perfusion. The procedures had a complication-free course with a good aesthetic result. Plastic surgeons may be reluctant to perform a full abdominoplasty in patients with a previous subcostal incision. In this preliminary analysis, we raise the potential usefulness of thermography for patients with recent subcostal scars and/or important comorbidities as a strategy for adequate patient and technique selection, avoiding possible complications. Future studies, with an increased number of patients and adequate statistical analysis, may allow us to validate the utility of thermography in these cases and reassure that the presence of previous extensive subcostal scars may not be a contraindication for a full abdominoplasty, especially if they are not recent.