Maura Brioschi

Purpose To analyze surface skin temperature with infrared thermography (IRT) in the regions of the temporal, masseter, and buccinator muscles during breastfeeding before and after LF. Methods Non-randomized clinical trial in 40 infants diagnosed with ankyloglossia. The lingual frenulum was assessed with the Neonatal Tongue Screening Test, breastfeeding was assessed with a protocol and pain scale, and the regions of interest were qualitatively and quantitatively assessed with IRT. Two independent evaluators analyzed the data. Results There were post-LF improvements in the functional-anatomical tongue assessment (p < 0.001), breastfeeding pain scale (p < 0.001), and breastfeeding assessment regarding the mother’s general aspect (p < 0.001), breast pain (p = 0.03), and suction (p < 0.001). IRT data after LF showed a qualitative increase in temperature in the regions of the temporal and masseter muscles. There was no difference in the region of the buccinator muscle. Conclusion LF impacts the surface skin temperature in the regions of mandibular levator muscles during breastfeeding.

Background: Type 2 diabetes mellitus (T2DM) is a complex disorder involving both hormonal imbalance and autonomic dysfunction. While bariatric surgery enhances glycemic control, its effects on autonomic regulation are limited. Objective: This is the first report describing two novel robotic surgical strategies targeting dual physiological mechanisms—hormonal modulation and sympathetic overactivity—to optimize metabolic outcomes in T2DM. The manuscript is intended to spark discussion around future surgical strategies based on two proof-of-concept index cases. Methods: We present two patients with poorly controlled T2DM. Case 1 underwent robotic ileal interposition with sleeve gastrectomy and duodenal exclusion, aiming to enhance incretin response and reduce glucagon levels. Case 2 underwent sleeve gastrectomy and duodenoileal interposition combined with selective hepatic sympathectomy, targeting sympathetic overactivity and autonomic dysfunction. Both procedures were performed using a robotic platform to enhance surgical precision. Results: Both procedures were completed successfully with minimal complications. The first patient showed significant weight loss and reduced insulin requirements after 12 months. The second patient reported resolution of sleep apnea symptoms and decreased paresthesia in the lower limbs, suggesting autonomic improvement. Conclusion: These cases highlight the safety, feasibility, and physiological rationale of combining robotic metabolic procedures with targeted autonomic modulation. This integrated approach may offer a promising pathway for treating complex metabolic disorders by addressing both hormonal and neural dysfunction. Further studies are warranted to validate these findings.

Mechanization in timber harvesting has improved the comfort and safety of operator workstations. However, there is an imminent ergonomic risk in relation to the repetition of movements, which can cause musculoskeletal injuries. The aim of this study was to apply infrared thermography to identify musculoskeletal overload in the hand region of harvester operators. This study was conducted on wood harvesting of homogeneous Eucalyptus urophylla × Eucalyptus grandis stands using a forestry harvester tractor. Thermographic images were taken of seven operators at the beginning and end of the working day during six days of the shift. The maximum, average, and minimum temperatures were measured in 14 hand regions of interest (ROI), verifying the existence of a difference between the beginning and the end of work (p-value < 5%) by using the Mann–Whitney test. The operators presented hyperradiant temperature variation in the hand region after work, with a variation above 2.5 °C, indicating a high degree of abnormality. There was greater temperature variation in the right hand (3.7 °C) due to the greater concentration of commands on the machine’s right joystick. Infrared thermography has proven to be an important tool for functional imaging diagnosis, contributing to the reduction in risks of developing Repetitive Strain Injury/Work-Related Musculoskeletal Disorder (RSI-WMSD).

Background/Objectives: Breast cancer-related lymphedema (BCRL) is a chronic condition that has early diagnosis as a critical component for proper treatment. Thermography, a non-invasive imaging method, is considered a promising complementary tool for the diagnosis and monitoring of BCRL, especially in subclinical stages. The present study aimed to evaluate the intra- and inter-examiner reproducibility of thermography for measuring the skin temperature of the upper limbs (UL) of women with and without BCRL. Methods: This study, conducted with women who underwent a unilateral mastectomy, assessed BCRL using indirect volumetry. Maximum, minimum, and mean skin temperatures were measured in five regions of interest (ROI) of each UL (C1, C2, C3, C4, and Cup) in four different postures. Reproducibility measures were assessed using an intraclass correlation coefficient, 95% confidence interval, and coefficient of variation. Results: The sample comprised 30 women; 14 were diagnosed with BCRL. A total of 120 thermograms were recorded in different postures, and 3600 ROI were analyzed in the UL with and without BRCL. The intraclass correlation coefficient of the analyses indicated intra- and inter-examiner reproducibility from good to excellent (0.82 to 1.00) for all skin temperatures evaluated (maximum, minimum, and mean). The coefficient of variation for all measures was below 10%, indicating low variability. Conclusions: Our findings demonstrate that thermography shows good-to-excellent reproducibility across multiple postures and regions of interest, reinforcing its potential as a non-invasive and reliable method for assessing lymphedema in breast cancer survivors. This study establishes a foundation for incorporating thermography into clinical practice for early BCRL detection, particularly in subclinical stages, thus improving patient management and outcomes.

Background/Objectives: Infrared thermography (IRT) is an imaging technique used in clinical practice to detect changes in skin temperature caused by several dysfunctions, including breast cancer-related lymphedema (BCRL). Thus, the present study aimed to assess the reproducibility and accuracy of IRT in diagnosing BCRL. Methods: This cross-sectional study included participants who underwent a unilateral mastectomy and used indirect volumetry for lymphedema detection. IRT analysis was recorded in four positions, analyzing maximum, mean, and minimum temperatures, as well as the temperature differences between the upper limbs. The analysis encompassed reliability, agreement, accuracy, and the establishment of cut-off points for sensitivity and specificity. A total of 88 upper limbs were included; 176 thermograms were captured, and 1056 regions of interest were analyzed. Results: IRT presented excellent intra- and inter-rater reproducibility and reliability with excellent intraclass correlation coefficient values (0.99 to 1.00). In addition, this assessment reached a sensitivity of 85% and a specificity of 56%; the cut-off point considered a temperature difference of −0.45 °C. Conclusions: IRT was a reliable and reproducible assessment, and the temperature difference between the upper limbs evidenced moderate accuracy. Thus, IRT is recommended as a complementary technique for detecting BCRL.

Resumo: Objetivo O presente trabalho teve como objetivo analisar o uso das imagens térmicas como ferramenta de auxílio ao diagnóstico de disfunções no tendão patelar. Métodos Realizou-se uma revisão sistemática da literatura, seguindo o protocolo PRISMA com busca nas bases de dados internacionais: Web of Science, SCOPUS, e Pubmed . Foram utilizados descritores em Inglês com a seguinte combinação ("thermal imaging" OR thermography OR "Infrared image" OR "Skin Temperature" OR "thermal image" OR "Infrared imaging") AND ("patellar tendon"). A avaliação da qualidade metodológica dos trabalhos selecionados foi realizada por dois avaliadores de forma independente pelo instrumento Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). Resultados Foram selecionados seis artigos originais. Três trabalhos avaliaram as alterações da temperatura da pele em situações patológicas. Outros dois trabalhos avaliaram a confiabilidade e reprodutibilidade da termografia especificamente na região do tendão patelar, e um artigo monitorou a temperatura da pele antes e após dois protocolos de treinamento físico. Conclusão Pode-se concluir que o uso das imagens térmicas se mostrou uma excelente ferramenta de apoio ao diagnóstico a disfunções na região do tendão patelar, bem como para o monitoramento das alterações fisiológicas dessa região também em condições não patológicas, como durante a prática de treinamento físico.