The identification of higher forefoot temperatures associated with peripheral arterial disease in type 2 diabetes mellitus as detected by thermography

Gatt, Alfred; Cassar, Kevin; Falzon, Owen; Ellul, Christian; Camilleri, Kenneth P.; Gauci, Jean; Mizzi, Stephen; Mizzi, Adrian; Sturgeon, Cassandra; Chockalingam, Nachiappan; Formosa, Cynthia

doi:10.1016/j.pcd.2018.01.001

Cited by 20 publications

(18 citation statements)

References 25 publications

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“…Perhaps if the limb elevation was maintained for a longer period of time, the vascular changes would have been sufficient to cause a change in temperature that could have been detected by the sensitive thermal camera. As in our previous studies [9,10], but in contrast with other works [6,7], again patients with PAD exhibited higher foot temperatures. Based on our results, higher temperatures are recorded in PAD, and therefore this may be used as a potential diagnostic tool.…”

Section: Discussionsupporting

confidence: 70%

“…A number of studies have shown that there is a decrease in cutaneous temperatures of the foot in patients with PAD when compared to patients without PAD [6][7][8]. In contrast, Gatt et al [9,10] have shown that, somewhat surprisingly, PAD in diabetes presents with higher temperatures similar to the other complications of this disease, including neuropathy and neuroischaemia. Notwithstanding the fact that baseline thermographic data of healthy adults exists [11], together with data of persons with diabetes, PAD and neuropathy, medical thermography, with its advantages of non-invasive and non-contact assessment of radiating temperature, is still not an accepted clinical tool for the identification of these conditions, apart from the identification of unilateral disease processes which can be compared to the unaffected foot.…”

Section: Discussionmentioning

confidence: 99%

“…All thermal images were obtained utilizing a FLIR (Oregon, USA) SC630 uncooled bolometer camera placed 1.5 m away from the feet of the supine participant who had been acclimatized for 15 min in a room at 23°C as per accepted protocols [9][10][11]. It was ensured that the camera was placed on a tripod perpendicular to the plane of the feet to be imaged.…”

Section: Thermal Image Capturementioning

confidence: 99%

“…One possible explanation for this high heat emissivity could be due to an alteration in normal mechanisms that regulate temperature in the feet. Local ischaemia may lead to disruption of sympathetically mediated noradrenergic vasoconstriction, leading to increased flow to the cutaneous vessels rather than through the deeper arteries, thus leading to this higher heat emissivity [9].…”

Section: Mean Standard Deviation Minimum Maximummentioning

confidence: 99%

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Thermographic Characteristics of the Diabetic Foot With Peripheral Arterial Disease Using the Angiosome Concept

Carabott

Formosa

Mizzi

et al. 2019

Exp Clin Endocrinol Diabetes

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Aim To compare temperature changes following a challenge of limb elevation, in 3 forefoot angiosomes between type 2 diabetes mellitus patients with and without peripheral arterial disease (PAD). Methods Participans were categorized in a no PAD, mild PAD or severe PAD group. All underwent thermal imaging, then successive thermal images were taken at 1 min intervals after the lower limbs were elevated for 5 min. Thereafter, the lower limbs were lowered to the original position and imaged after 1 min. Mean temperatures of the hallux, medial and lateral forefoot were analysed by the angiosome concept. Results Forty-two limbs were analysed. Mean resting temperatures of all angiosomes of participants with PAD were higher than those with no peripheral arterial disease. A significant difference in the mean initial temperature between the groups was found in the medial and lateral forefoot angiosomes (p=0.048, p=0.049 respectively), whilst at the hallux these temperatures were not significant (p=0.165). After limb elevation, the only significant difference was seen in the lateral foot area at 1 min (p=0.021). Conclusions These results confirm that patients with PAD exhibit significantly higher forefoot temperatures, according to the angiosome concept. The challenge by foot elevation did not affect the thermal pattern significantly.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Thermal Image Capturementioning

confidence: 99%

Section: Mean Standard Deviation Minimum Maximummentioning

confidence: 99%

See 2 more Smart Citations

Thermographic Characteristics of the Diabetic Foot With Peripheral Arterial Disease Using the Angiosome Concept

Carabott

Formosa

Mizzi

et al. 2019

Exp Clin Endocrinol Diabetes

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“… 11 Hand temperature distribution 16 and foot thermal distribution were used to identify peripheral arterial disease. 17 , 18 Differences between peripheral organs (ears) and core body temperature 19 and thermal gradient along the arm 20 were used for shock diagnosis.…”

Section: Technologies and Challengesmentioning

confidence: 99%

Technological Developments and Strategic Management for Overcoming the COVID-19 Challenge within the Hospital Setting in Israel

Abbo¹,

Miller²,

Gazit³

et al. 2020

Rambam Maimonides Med J

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The coronavirus disease 2019 (COVID-19) pandemic has remarkably challenged health care organizations and societies. A key strategy for confronting the disease implications on individuals and communities was based on harnessing multidisciplinary efforts to develop technologies for mitigating the disease spread and its deleterious clinical implications. One of the main challenging characteristics of COVID-19 is the provision of medical care to patients with a highly infective disease mandating the use of isolation measures. Such care is complicated by the need for complex critical care, dynamic treatment guidelines, and a vague Technologies for COVID-19 Challenge Rambam Maimonides Medical Journal 2 July 2020  Volume 11  Issue 3  e0026 knowledge regarding the disease's pathophysiology. A second key component of this challenge was the overwhelming surge in patient burden and the relative lack of trained staff and medical equipment which required rapid reorganization of large systems and augmenting health care efficiencies to unprecedented levels. In contrast to the risk management strategies employed to mitigate other serious threats and the billions of dollars that are invested in reducing these risks annually by governments around the world, no such preparation has been shown to be of effect during the current COVID-19 pandemic. Unmet needs were identified within the newly opened COVID-19 departments together with the urgent need for reliable information for effective decision-making at the state level. This review article describes the early research and development response in Israel under the scope of in-hospital patient care, such as non-contact sensing of patients' vital signs, and how it could potentially be weaved into a practical big picture at the hospital or national level using a strategic management system. At this stage, some of the described technologies are still in developmental or clinical evidence generation phases with respect to COVID-19 settings. While waiting for future publications describing the results of the ongoing evidence generation efforts, one should be aware of this trend as these emerging tools have the potential to further benefit patients as well as caregivers and health care systems beyond the scope of the current pandemic as well as confronting future surges in the number of cases.

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Thermography as a Diagnostic Tool for Early Detection of Diabetic Foot Ulceration Risk: A Review

Salazar

Zequera

2019

IFMBE Proceedings

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The identification of higher forefoot temperatures associated with peripheral arterial disease in type 2 diabetes mellitus as detected by thermography

Cited by 20 publications

References 25 publications

Thermographic Characteristics of the Diabetic Foot With Peripheral Arterial Disease Using the Angiosome Concept

Thermographic Characteristics of the Diabetic Foot With Peripheral Arterial Disease Using the Angiosome Concept

Technological Developments and Strategic Management for Overcoming the COVID-19 Challenge within the Hospital Setting in Israel

Thermography as a Diagnostic Tool for Early Detection of Diabetic Foot Ulceration Risk: A Review

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