Thermographic characterization of masticatory muscle regions in volunteers with and without myogenous temporomandibular disorder: preliminary results.

OBJECTIVES: This study aims to conduct a non-invasive measurement of the cutaneous temperature of selected masticatory muscle regions of volunteers with and without myogenous temporomandibular disorder (TMD), using infrared thermography. METHODS: 23 females (10 myogenous TMD volunteers and 13 controls) were recruited and studied. The temperature at the surface of the facial area over the anterior temporalis and masseter muscles was assessed by medical thermography, using regional lateral views and clinical examination. RESULTS: The temperature levels measured at the masseter and anterior temporalis muscle regions in myogenous TMD volunteers (32.85 ± 0.85 and 34.37 ± 0.64 ºC, respectively) were significantly lower (p < 0.05) than those measured in controls (33.49 ± 0.92 and 34.78 ± 0.44 ºC, respectively). Medical infrared imaging indicated a mean difference of 1.4 ºC between the masseter and anterior temporalis regions. Analysis of the comparison between the absolute and normalized mean temperatures was performed using the pairwise comparison of receiver operating characteristic curves, and no statistically significant difference was observed (p > 0.05). The sensitivity and specificity of the thermographic assessment for the masseter region was of 70% and 73%, respectively and for the anterior temporalis region was of 80% and 62%, respectively. CONCLUSIONS: This method of evaluating masticatory muscle regions of this preliminary study seems to indicate that it can be used as an aid in complimentary diagnosing of TMDs.

Thermographic and clinical correlation of myofascial trigger points in the masticatory muscles.

OBJECTIVES: The aim of the study was to identify and correlate myofascial trigger points (MTPs) in the masticatory muscles, using thermography and algometry. METHODS: 26 female volunteers were recruited. The surface facial area over the masseter and anterior temporalis muscles was divided into 15 subareas on each side (n=780). This investigation consisted of three steps. The first step involved thermographic facial examination, using lateral views. The second step involved the pressure pain threshold (PPT), marking the MTP pattern areas for referred pain (n=131) and local pain (n=282) with a coloured pencil, and a photograph of the lateral face with the head in the same position as the infrared imaging. The last step was the fusion of these two images, using dedicated software (Reporter® 8.5-SP3 Professional Edition and QuickReport® 1.2, FLIR Systems, Wilsonville, OR); and the calculation of the temperature of each point. RESULTS: PPT levels measured at the points of referred pain in MTPs (1.28±0.45 kgf) were significantly lower than the points of local pain in MTPs (1.73±0.59 kgf; p<0.05). Infrared imaging indicated differences between referred and local pain in MTPs of 0.5 °C (p<0.05). Analysis of the correlation between the PPT and infrared imaging was done using the Spearman non-parametric method, in which the correlations were positive and moderate (0.4≤r<0.7). The sensitivity and specificity in MTPs were 62.5% and 71.3%, respectively, for referred pain, and 43.6% and 60.6%, respectively, for local pain. CONCLUSION: Infrared imaging measurements can provide a useful, non-invasive and non-ionizing examination for diagnosis of MTPs in masticatory muscles.

A thermodynamic model to predict the thermal response of living beings during pneumoperitoneum procedures.

In this work, hypothermia associated with pneumoperitoneum procedures is studied. A thermodynamic model is developed to allow for the computational simulation of the thermal body response to pneumoperitoneum procedures, which are required by laparoscopic surgery. The numerical results predict the body temperature decay (or loss of energy) in time when the pneumoperitoneum procedures is conducted in patient. The influence of several operating parameters (e.g. inlet air mass flow rate and temperature) on the resulting hypothermia level is analysed. Therefore, the model allows the identification of parameters that have to be controlled to minimize the loss of energy, and consequently, the hypothermia level due to pneumoperitoneum procedures.

Incidência de S aureus Meticilino-resistente (MRSA) em estetoscópios de uso hospitalar / Methicillin-resistant (MRSA) S aureus

Foram colhidas prospectivamente 150 amostras para cultura de microrganismos de estetoscópios utilizados rotineiramente no hospital por acadêmicos de Medicina, médicos e enfermeiros. Realizou-se in print direto do diagragma e swab das reentrâncias dos estetoscópios em meio de cultura ágar-sangue. Os germes foram identificados através das provas padrões. A resistência à oxacilina/meticilina foi identificada por antibiograma através do método de Kirby-Bauer e semeadura em spot. Neste estudo os estetoscópios demonstraram ser reservatórios de agentes infecciosos, demonstrando bactérias em 91,3 por cento deles. A incidência em médicos, acadêmicos e enfermeiros foi, respectivamente, 87,9 por cento, 89,3 por cento e 97,7 por cento, nos diafragmas, e 96,5 por cento, 91,3 por cento e 75 por cento, respectivamente, nas reentrâncias. Entre os estafilococos presentes, 7,3 por cento eram meticilino-sensíveis e 2 por cento eram meticilino-resistentes no diafragma, e 5,3 por cento meticilino-sensíveis e 1,3 por cento meticilino-resistentes nas reentrâncias. Os autores sugerem a desinfecção do diafragma com álcool a 70 por cento antes do atendimento de cada paciente para evitar a possível disseminação destes germes