Thermography hand temperature distribution in rheumatoid arthritis and osteoarthritis

Background and Purpose: Earliest written medical text from ancient Egypt mentioned temperature as an indicator of a disease. Although already known, thermal imaging has not been routinely used in medicine. Inflammation of peripheral joints, close to skin surface, is the dominant type of presentation of rheumatoid arthritis and due to that, those joints are suitable for infrared thermal scanning. Considering the changes of the bones in the affected joints, as a control group, apart from healthy subjects, study was conducted on patients with osteoarthritis as well. Purpose of this paper was to investigate thermal images of the hands of patients with rheumatoid arthritis and osteoarthritis and analyze temperature distribution. Materials and Methods: Thermographic images of both hands of healthy subjects, patients with rheumatoid arthritis and patients with osteoarthritis were made. On thermal images obtained, temperature distribution of certain regionswas analyzed. Basic statistical analyses (minimum,maximum, standard deviation, mean, and variance) were performed. Results: There is a statistically significant difference in finger andmetacarpophalangeal joint mean temperature values on ventral and dorsal sides for both healthy patients and patients with rheumatoid arthritis and osteoarthritis. Also, there is a statistically significant difference of mean temperature values between the aforementioned patient groups. Temperature distribution curves of patients with osteoarthritis have been narrower than those of subjects with rheumatoid arthritis and normal subjects. Temperature distribution curves of patients with rheumatoid arthritis have been shifted towards higher temperatures than those of subjects with osteoartritis and normal subjects. Conclusion: From the results obtained it was concluded that heat distribution over the skin surface apart from depending on the affected joint and on the intensity of the disease and given drug therapy also differs between the patients with rheumatoid arthritis and osteoarthritis, making the use of thermography a possible method of differentiating normal subjects and rheumatoid arthritis subjects and osteoarthritis subjects from each other

Simplified description and interpretation of pathological thermography signs in malignant breast lesions

Background and Purpose: Breast cancer is the leading cause of death among women aged 20–59 years in developed countries, with similar mortality trends, observed among women in Croatia. Breast cancer detection usually relies on mammography, ultrasound (US) and magnetic resonance imaging (MRI), however, thermography is a noninvasive, reliable and applicable diagnostic procedure for early detection of breast disease that has attracted interest in this field. The aim of this study was to establish the frequency and characteristics of pathological thermographic signs in female patients, who were operated on malignant breast lesions. In addition, the authors offered a simplified description and interpretation of pathological thermographic signs, based on published literature. Matherial and Methods: The seventy four female patients with histopathologically confirmed breast cancer were included in the study. In all patients breast cancer was diagnosed using standard protocol which have included clinical examination, mammography, ultrasound and for selected patients MRI and/or fine needle aspiration (FNA). Thermographic imaging has been conducted 1 to 14 days before scheduled surgical procedures. Results: Mean tumor size positively correlated with number of pathological thermographic signs (IR 3 vs. IR 5, p < 0.05). Mean number of pathological thermographic signs per patient was 3.5±1, 72 (range 1 to 8). The most frequently noted singular signs were heat in area of finding and vascular signs, as well. Conclusion: The simplified description could offer a suitable clinical tool for standardization of pathological thermography signs in malignant breast lesions, taking into account the learning curve of medical teams involved and ethical aspects, as well

Termografija skrotuma u procjeni ishoda operacije varikokele: prikaz slučaja

Scrotal thermography is a diagnostic method for varicocele. In short, there are five diagnostic thermographic criteria for varicocele, i.e., pattern of scrotal thermographic image indicative of varicocele, temperature at pampiniform plexus ≥34 C°, temperature difference between left and right pampiniform plexus ≥0.5 C°, enhancement of image during Valsalva maneuver, and temperature at pampiniform plexus ≥ temperature at ipsilateral thigh. Three or more positive signs are indicative of varicocele. The aim of this report is to present the use of digital thermography as a diagnostic method to evaluate the outcome of varicocele repair. We present a case of a student diagnosed with varicocele grade III, and assessed preoperatively and followed up postoperatively by scrotal thermography. According to thermographic indicators, our patient was positive for varicocele diagnosis before surgical treatment. Three months after varicocele repair, the patient did not show positive thermographic indicators of varicocele while physical examination and color Doppler ultrasound were equivocal. This case report suggests that infrared digital thermography of scrotum could be very valuable for monitoring patients in the period after surgery for varicocele, however, it should be confirmed in a larger number of patients.Termografija skrotuma je metoda dijagnostike varikokele. Postoji pet termografskih dijagnostičkih kriterija za dijagnozu varikokele: termografski prikaz karakterističan za varikokelu, temperatura pampiniformnog pleksusa ≥34 C°, razlika temperature između lijevog i desnog pampiniformnog pleksusa ≥0,5 C°, indikativna promjena slike prilikom Valsalvina manevra i temperatura pampiniformnog pleksusa koja je ≥ temperaturi ipsilateralne natkoljenice. Tri ili više pozitivnih znakova predstavlja pozitivan nalaz u slučaju dijagnostike varikokele. Cilj ovoga rada je prikazati primjenu termografije skrotuma kao dijagnostičke metode u procjeni ishoda operacije varikokele. Prikazat ćemo slučaj studenta koji je imao dijagnozu varikokele III. stupnja te je prijeoperacijski dijagnosticiran, a poslijeoperacijski praćen termografijom skrotuma. Prema termografskim kriterijima ovaj bolesnik je prijeoperacijski imao varikokelu. Tri mjeseca nakon operacije bolesnik nije imao pozitivne termografske znakove za varikokelu, međutim, klinički pregled i obojeni doppler nisu bilo tako uvjerljivi. Ovaj prikaz slučaja pokazuje mogućnost primjene termografije skrotuma u praćenju bolesnika nakon operacije varikokele, no ovo svakako treba potvrditi na većem broju ispitanika

Thermography in patients with inflammatory bowel disease and colorectal cancer: evidence and review of the method

Background and Purpose: There is a need for a simple, noninvasive and reproducible test that could accurately reflect the inflammatory activity and neoplastic lesions, and that could be used safely and repeatedly during the biological course of inflammatory and neoplastic bowel disease. During past few decades, the joint efforts of professionals have resulted in evolution of technological advances in infrared sensor technology, thus developing the new methods that enabled the use of thermal imaging in biomedical research and clinical medicine. The aim of this viewpoint was to present, and comment on,the possibility of thermal imaging in assessing inflammatory disease activity and the existence of neoplastic bowel lesions. Materials and Methods: The authors presented thermal images of several patients (n=6: five patients with inflammatory bowel disease and one female patient with colorectal cancer), and one female healthy individual, describing the tem erature patterns and commenting on the possible thermographic signs of underlying disease. Results: Inflammatory bowel disease and colorectal cancer show a clear change in the thermal pattern of the abdominal surface and a different pattern of histogram temperature distribution. Conclusion: This review has indicated the potential of infrared thermography as a feasible and noninvasivemethod in additional evaluation of patients with various manifestations of inflammatory bowel disease and also of colon cancer

Reforma zdravstvenog sustava

Najveći problem u provođenju reforme zdravstvenog sustava je stanje opće rezignacije ( kako pučanstva tako i profesionalaca ) tako da potrebu za reformom ne ističe niti jedna interesna skupina, pa je prvi zadatak naše male skupine da nametnemo temu. Kako da u zemlji u kojoj je "ŽUJA ZAKON" , "DINAMO JE SVETINJA, OSTALO JE SRANJE" uspijemo istaknuti problem zdravlja, kao polaznu osnovu uspješnog sveopćeg oporavka

Comparison of the oxidative reactivity of recombinant fetal and adult human hemoglobin: implications for the design of hemoglobin-based oxygen carriers.

Hemoglobin based oxygen carriers (HBOCs) have been engineered to replace or augment the oxygen carrying capacity of erythrocytes. However, clinical results have generally been disappointing due, in part due to the intrinsic oxidative toxicity of hemoglobin. The most common HBOC starting material is adult human or bovine hemoglobin. However, it has been suggested that fetal hemoglobin may offer advantages due to decreased oxidative reactivity. Large scale manufacturing of a HBOC will likely ultimately require recombinant sources of human proteins. We therefore directly compared the functional properties and oxidative reactivity of recombinant fetal (rHbF) and recombinant adult (rHbA) hemoglobin. rHbA and rHbF produced similar yields of purified functional protein. No differences were seen in the two proteins in: autoxidation rate; the rate of hydrogen peroxide reaction; NO scavenging dioxygenase activity; and the NO producing nitrite reductase activity. The rHbF protein was: less damaged by low levels of hydrogen peroxide; less damaging when added to human umbilical vein endothelial cells (HUVEC) in the ferric form; and had a slower rate of intrinsic heme loss. The rHbA protein was: more readily reducible by plasma antioxidants such as ascorbate in both the reactive ferryl and ferric states; less readily damaged by lipid peroxides; and less damaging to phosphatidylcholine liposomes. In conclusion in terms of oxidative reactivity there are advantages and disadvantages to the use of recombinant adult or fetal Hb as the basis for an effective HBOC

The value of scrotal infrared digital thermography in detection of varicocele – initial results

is associated with male infertility, as it is found in more than 40% of male partners in infertile couples. The main pathophysiological mechanism for impaired spermastogenesis is considered to be elevated scrotal temperature. Mainstay for diagnostic assessment of varicocele is physical examination and scrotal ultrasound/doppler. Thermography is a diagnostic method which measures temperature differences across the skin surface using a highly sensitive infrared camera. Currently there is no consensus regarding diagnostic parameters for thermography in diagnosis of varicocele. Aim of this study is to examine application of digital thermography in diagnosing varicocele. Material and Methods: Study group consisted of 10 patients of mean age 18.2 ± 2.4 (range=15.5 to 23.7). In all patients varicocelewas detected incidentally on routine physical examination. All patients were evaluated by three methods. Infrared digital thermography was followed by physical examination and ultrasound/doppler. Infrared camera Thermo Tracer TH7102WL (NEC Sanei Instruments, Ltd., Japan) was used during all measurements. This infrared system has a geometric resolution of 76.800 pixels per picture (320 ´ 240) and the minimum detectable temperature resolution (difference) is 0.07° C at 30°C (Normal mode). Results: Mean temperature at left pampiniforum plexus was 34.65 ± 0.66°C (range=34.1 to 36.3°C) and at right pampiniform plexus 32.53 ± 0.78°C (range=31.5 to 33.5°C). Temperature at left testicle was 33.58 ±0.97°C (range=32.1–35°C) while at right testicle it was 32.19 ± 0.81°C (range = 31.2 to 33.5°C). Temperature at pampiniform plexus higher than 34°C presents main thermographic sign of varicocele, while temperature at testicle higher than 32°C is indicative of varicocele. Temperature difference between left and right pampiniform plexus was 2.12 ± 1.08°C (range=0.9 to 4.7°C), and between testicles was 1.39 ± 1.20°C (range= 0.1 to 3.6°C). Thermography successfully confirmed varicocele diagnosis in all patients. Conclusion: Digital infrared thermography presents feasible and low cost diagnostic method for varicocele. Further study on a larger number of patients and healthy participants is needed to evaluate sensitivity and specificity of this method and to establish consistent diagnostic parameters for thermographic assessment of varicocele

Simplified description and interpretation of pathological thermography signs in malignant breast lesions

Background and Purpose: Breast cancer is the leading cause of death among women aged 20–59 years in developed countries, with similar mortality trends, observed among women in Croatia. Breast cancer detection usually relies on mammography, ultrasound (US) and magnetic resonance imaging (MRI), however, thermography is a noninvasive, reliable and applicable diagnostic procedure for early detection of breast disease that has attracted interest in this field. The aim of this study was to establish the frequency and characteristics of pathological thermographic signs in female patients, who were operated on malignant breast lesions. In addition, the authors offered a simplified description and interpretation of pathological thermographic signs, based on published literature. Matherial and Methods: The seventy four female patients with histopathologically confirmed breast cancer were included in the study. In all patients breast cancer was diagnosed using standard protocol which have included clinical examination, mammography, ultrasound and for selected patients MRI and/or fine needle aspiration (FNA). Thermographic imaging has been conducted 1 to 14 days before scheduled surgical procedures. Results: Mean tumor size positively correlated with number of pathological thermographic signs (IR 3 vs. IR 5, p < 0.05). Mean number of pathological thermographic signs per patient was 3.5±1, 72 (range 1 to 8). The most frequently noted singular signs were heat in area of finding and vascular signs, as well. Conclusion: The simplified description could offer a suitable clinical tool for standardization of pathological thermography signs in malignant breast lesions, taking into account the learning curve of medical teams involved and ethical aspects, as well

The value of scrotal infrared digital thermography in detection of varicocele – initial results

is associated with male infertility, as it is found in more than 40% of male partners in infertile couples. The main pathophysiological mechanism for impaired spermastogenesis is considered to be elevated scrotal temperature. Mainstay for diagnostic assessment of varicocele is physical examination and scrotal ultrasound/doppler. Thermography is a diagnostic method which measures temperature differences across the skin surface using a highly sensitive infrared camera. Currently there is no consensus regarding diagnostic parameters for thermography in diagnosis of varicocele. Aim of this study is to examine application of digital thermography in diagnosing varicocele. Material and Methods: Study group consisted of 10 patients of mean age 18.2 ± 2.4 (range=15.5 to 23.7). In all patients varicocelewas detected incidentally on routine physical examination. All patients were evaluated by three methods. Infrared digital thermography was followed by physical examination and ultrasound/doppler. Infrared camera Thermo Tracer TH7102WL (NEC Sanei Instruments, Ltd., Japan) was used during all measurements. This infrared system has a geometric resolution of 76.800 pixels per picture (320 ´ 240) and the minimum detectable temperature resolution (difference) is 0.07° C at 30°C (Normal mode). Results: Mean temperature at left pampiniforum plexus was 34.65 ± 0.66°C (range=34.1 to 36.3°C) and at right pampiniform plexus 32.53 ± 0.78°C (range=31.5 to 33.5°C). Temperature at left testicle was 33.58 ±0.97°C (range=32.1–35°C) while at right testicle it was 32.19 ± 0.81°C (range = 31.2 to 33.5°C). Temperature at pampiniform plexus higher than 34°C presents main thermographic sign of varicocele, while temperature at testicle higher than 32°C is indicative of varicocele. Temperature difference between left and right pampiniform plexus was 2.12 ± 1.08°C (range=0.9 to 4.7°C), and between testicles was 1.39 ± 1.20°C (range= 0.1 to 3.6°C). Thermography successfully confirmed varicocele diagnosis in all patients. Conclusion: Digital infrared thermography presents feasible and low cost diagnostic method for varicocele. Further study on a larger number of patients and healthy participants is needed to evaluate sensitivity and specificity of this method and to establish consistent diagnostic parameters for thermographic assessment of varicocele