Viscerocutaneous reflexes with abdominal wall pain: A study conducted in 1981 on pregnant women from a general practice

Viscerocutaneous reflexes with abdominal wall pain: A study conducted in 1981 on pregnant women from a general practice

Phe van der Veen

Thermology International 04/2013; 23(2):56-63.

ABSTRACT BACKGROUND: This is an article regarding an unpublished study that was designed and conducted in 1981, but publication in time was not possible due to the workload in the busy practice of the author. Temperature changes on the abdominal wall could be caused by nociceptive sensations in the viscera which are transfered to the surface via viscerocutaneous reflex pathways. Two aspects play a role in this: 1. An internal organ’s proximity to the skin, 2. That organ’s registration of function to the skin. This study addresses the registration of function of an organ on a specific site of the skin. The aim of the study was to investigate if infrared thermography can measure temperature changes associated with the functional status of a pregnancy. The null hypothesis was: during the course of pregnancy, there is no difference in skin temperature between the skin areas selected.

METHODOLOGY: The occurrence of viscerocutaneous reflexes was investigated by means of infrared thermography in a group of pregnant women who were cared for in a general medical practice.This observational study started on the first visit for a pregnancy check-up and at every check-up visit, the temperature was measured. Because the check-ups were scheduled by the doctor based on indications or on woman’s request, the number of measurement differs among women. We used a linear mixed-effects model to model the difference in temperature between the genital zone and navel zone, with week and complaint group as fixed effects.

INTERVENTION: On four areas of the abdominal wall, infrared thermography temperature measurements were taken on the abdominal skin.

RESULTS: During pregnancy, a significant temperature difference developed between the genital zone and the navel zone (t=-6.019), caused by lower temperature in the genital zone that became visible approximately in the 34th week of the pregnancy.

CONCLUSIONS: The null hypothesis should be rejected. Infrared thermography seems to be able to measure the viscero- cutaneous consequences of a visceral process on a physiological level. The investigation with pregnant women reported in this publication is relevant for two reasons, because the evidence based data show that: 1. Infrared thermography can play a role in the detection of processes in the viscerum. 2. Chronic pain of the abdominal wall cannot be an isolated entity. This confirms extensively documented literature published previously. Abdominal wall pain continues to be a major problem medically, economically, and socially. Abdominal problems must be ruled out explicitly when searching for the location of abdominal wall pain. Differential diagnostics are a prerequisite for determining a specific solution.

Infrared thermography in newborns: the first hour after birth.

Christidis I, Zotter H, Rosegger H, Engele H, Kurz R, Kerbl R. Department of Pediatrics, University of Graz, Austria.

OBJECTIVE: It was the aim of this study to investigate the surface temperature in newborns within the first hour after delivery. Furthermore, the influence of different environmental conditions with regard to surface temperature was documented.

METHODS: Body surface temperature was recorded under several environmental conditions by use of infrared thermography. 42 newborns, all delivered at term and with weight appropriate for date, were investigated under controlled conditions.

RESULTS: The surface temperature immediately after birth shows a uniform picture of the whole body; however, it is significantly lower than the core temperature. Soon after birth, peripheral sites become cooler whereas a constant temperature is maintained at the trunk. Bathing in warm water again leads to a more even temperature profile. Radiant heaters and skin-to-skin contact with the mother are both effective methods to prevent heat loss in neonates.

CONCLUSIONS: Infrared thermography is a simple and reliable tool for the measurement of skin temperature profiles in neonates. Without the need of direct skin contact, it may be helpful for optimizing environmental conditions at delivery suites and neonatal intensivecare units."

Ref. S. Karger AG, Basel

Thermology and facial telethermography: Part II. Current and future clinical applications in dentistry.

Gratt BM, Anbar M Section of Oral Radiology, UCLA School of Dentistry 90095-1668, USA.

Selected clinical applications using thermal imaging as an aid in dentistry are reviewed. Facial skin temperature can easily be measured in a clinical setting, without direct skin contact, by monitoring the emitted infrared radiation. This is the basis of static area telethermography (SAT) and dynamic area telethermography (DAT). SAT has recently been shown to be of help to the dentist in (1) the diagnosis of chronic orofacial pain, (2) as a unique tool in assessment of TMJ disorders, (3) as an aid in assessment of inferior alveolar nerve deficit, and (4) as a promising research tool. DAT, recently made possible by advances in computing technology combined with advanced infrared sensor technology, extracts quantitative information about hemodynamic processes from hundreds to thousands of digital thermal images of the affected facial areas, measured and collected within less than 3 min. DAT has promise of offering a better insight into aberrations of the neuronal control of facial skin perfusion and aiding our understanding of the correlation between orofacial pain and facial thermal abnormalities. This promising new insight may help in the management of orofacial pain.