RU2545423C2 - Method of disease monitoring - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, in particular to a method of disease monitoring by measuring the temperature of body parts. The method is based on single loading into computer memory of the image of an examined area with marked on it points for temperature measurement. Measurement of the temperature on the human body is performed in respective points, marked on the image. The measurement is realised repeatedly in a monitoring period with saving temperature values in computer memory. The temperature values, obtained in the same points in different monitoring sessions, are compared. Monitoring results are formed on the basis of the said comparison.

EFFECT: invention makes it possible to increase the accuracy of disease monitoring without participation of an expert, to simplify and to make cheaper obtaining information about the pathological process course and conclusion about treatment efficiency without participation of an expert.

56 dwg, 5 ex

Description

The present invention relates to medicine, to measurements for diagnostic purposes by measuring the temperature of parts of the body, namely to a method for monitoring diseases and a device for monitoring diseases for its implementation, which can be used to control the course of diseases and evaluate the effectiveness of treatment at home (outside health care facilities and / or without the participation of a specialist), in health care facilities, when conducting telemedicine consultations.

Monitoring in medicine usually refers to the process of systematic or continuous collection of information on the functioning of various organs and systems of the human body to control the course of diseases, early detection of exacerbations and determine the effectiveness of the treatment (http://en.wikipedia.org/wiki/Monitoring_%28medicine% 29).

In this application, the term monitoring refers to the process of periodically collecting information to monitor the course of previously established (diagnosed) diseases, early detection of exacerbations and determine the effectiveness of the treatment.

Currently, due to the presence of a huge number of highly specific devices and methods for diagnosis in the vast majority of clinical cases, there is no problem with an accurate diagnosis. However, for most of the most common diseases that are the main cause of death (vascular, inflammatory, oncological, etc.), there are no accurate, safe, and accessible to the average user devices for objectively monitoring the course of the disease / effectiveness of therapy at home.

Therefore, there is currently a great need of the population for simple and inexpensive devices designed to monitor diseases at home, similar to a blood pressure monitor (monitoring blood pressure, including hypertension and hypotension), a heart monitor (monitoring heart disease) and a blood glucose meter (monitoring level blood sugar, including diabetes mellitus). Successful satisfaction of this need is possible only by unifying the process of examination and self-examination, measuring the relevant indicators and their automated processing with the issuance of digital and / or textual indicators important for the patient.

It is well known that a digital thermometer that measures total body temperature is a sensitive but low-specific device for detecting and monitoring diseases. It is also widely known that many human diseases are accompanied by characteristic changes in skin surface temperature in certain areas of the body (the so-called local thermal signs of the disease). Information on the distribution of temperature values allows us to judge the presence of pathology in the body (Lahiri V.V., Bagavathiappan S., Jayakumar T., Philip J. Medical applications of infrared thermography: A review // Infrared Physics & Technology. - Volume 55, Issue 4, July 2012, P. 221-235). Thermal symptoms of diseases usually appear earlier than other clinical manifestations of the disease, and they noticeably change during treatment. Medical thermography, as well as measurement of total body temperature, at high sensitivity also has low specificity (Arora N, Martins D, Ruggerio D, et al .: Effectiveness of a noninvasive digital infrared thermal imaging system in the detection of breast cancer.// Am J Surg 196 (4): 523-6, 2008). As a result, the registration of the surface temperature of the skin areas of the body in the dynamics is an effective monitoring method.

Known methods for the diagnosis and monitoring of diseases based on the use of a number of devices for recording temperature values:

1. “Contact thermography” (for example, http://www.atm-charm.ru/stati) through the use of special plates on microencapsulated liquid crystals (E.L.C.) allows using various colors to display the temperature of the examined parts of the body. Contact thermography is most often used to determine changes in body temperature that have occurred in connection with the development of cellulite in its various stages. Advantages: ease of use, harmlessness, the possibility of multiple examinations. However, significant disadvantages do not allow the use of this technology in the framework of the invention, namely:

- the films have a limited size, therefore, cannot be superimposed on any examined area;

- the method does not allow to digitize and deliver to the computer numerical values of temperatures at the points of the surveyed area for subsequent automatic evaluation and interpretation of the resulting picture;

- the application of the method is limited to areas of the body with a minimally developed hairline and the smoothest relief, such as shins and thighs (for example, Hoffmann R, Largiader F, Brutsch HP. Liquid crystal contact thermography - a new screening procedure in the diagnosis of deep venous thrombosis / / Helv Chir Acta. 1989 Jun; 56 (l-2): 45-8).

2. Contact thermometers (for example, Microlife MT1671 - www.microlife.com/WebTools/ProductDB/pdf/IB%20MT%201671%20EN-RU%201310.pdf) - these are devices for measuring the temperature of objects by direct contact with them.

In medicine, contact thermometers are usually used to measure only the patient’s total body temperature orally, rectally, axially or in the external auditory canal. Contact thermometers have the following advantages:

- high accuracy - contact thermometers provide high-precision temperature measurement in all environments;

- high stability of measurement results - a series of measurements thermometers provide high repeatability of the results, because direct contact with the investigated object is provided.

However, a contact thermometer has significant disadvantages that do not allow it to be used in the framework of the invention, namely:

- high inertia during measurements, it takes time to achieve thermodynamic equilibrium between the sensitive element of the thermometer and the object; this time can be from several seconds to several minutes, which is unacceptable when carrying out a large number of measurements necessary for an adequate assessment of the temperature field of a certain area of the body;

- the need to ensure high-quality physical contact with the surface of the object for a long time, which in turn can lead to a change in temperature of the object itself. Accurately enough, you can measure the temperature only in places closed from the influence of ambient air (axilla, ear, etc.). It is impossible to accurately measure the temperature in open areas of the body using a contact thermometer.

A number of authors suggest diagnostic methods based on the use of contact temperature sensors connected to a computer, the data of which are used by a computer program to construct images of the temperature field on the examined area on a monitor screen (for example, EP 1326063 A1, 07.07.2003, RU2276965 C2, 27.05. 2006; RU 2003127766 A, 3/20/2005; RU 2267982 C2, 01/20/2006. RU 2007138079 A, 4/27/2009). The presence of pathology is detected by the deviation of temperature in the examined area of the body from the standard value, which is used as the average statistical value characteristic of healthy people, or an individual human norm, obtained by averaging the sensors when measuring temperature at several points in the examined area on the body.

The disadvantage of these methods is that the accuracy of reproducing the temperature field depends on the characteristics of the contact thermometers used, the readings of which at a particular point in time are determined by the condition of the skin, in particular its moisture. This requires a preliminary measurement of the dependence of the thermometer readings on the characteristics of the skin and the introduction of this dependence in the algorithm for processing the obtained data. In addition, the readings of the contact thermometer depend on the conditions for taking readings, for example, on the force of pressing the thermometer against the human body. For example, the auxiliary element proposed in the method RU 2007138079, 04/27/2009, in the form of a tightly compressing suit inevitably causes a greenhouse effect, as well as changes in local microcirculation and a violation of local heat transfer of the skin, which in principle eliminates the receipt of any adequate information about the temperature in the subject areas (“it is well known that before conducting a thermal imaging survey, the areas to be examined should be subjected to 10-15 minutes of adaptation to the temperature conditions of the room. E This time is enough to ensure that a constant temperature gradient is established between the skin temperature of exposed areas of the human body and the room temperature ....... ”Quoted from: Kolesov SN, Volovik MG, Priluchny MA Medical radiovision: modern methodological approach: Monograph. - Nizhny Novgorod: Federal State Institution “NNIITO Rosmedtehnologii”, 2008. - 184 pp. (pp. 70-71). In addition, in the discussed methods, the use of a combination of contact sensors does not provide for the exact positioning of each of them relative to the anatomical features of the examined area, therefore, the obtained information about the temperature values cannot be unambiguously compared with the individual image of the examined area.

In some of the methods (for example, EP 1326063, 07/09/2003, JP 2010194073, 09/09/2010) in the presence of the same disadvantages described above, the possibility of visualizing the temperature distribution is discussed, but in all cases we are only talking about constructing a discrete set of temperature values at the examined points in as a set of rectangular regions displaying these values (therefore, compared to real thermograms obtained using a thermal imager, such visualizations by displaying temperature values in color thermograms are in the conventional sense). The procedure for displaying the temperature field between the surveyed points is not provided, which excludes the construction and analysis of real thermograms.

Currently available infrared contact high-speed medical thermometers are intended mainly for measuring the total body temperature. It is generally accepted to evaluate the total body temperature by measuring the temperature of one of several areas of the body, namely the surface of the forehead and / or ear canal. Accordingly, existing infrared medical thermometers designed to measure total body temperature are structurally and functionally specialized for measuring temperature only in these areas of the body and are not intended to estimate the local temperature of an arbitrary part of the body.

There are also highly specialized infrared contact thermometers designed to assess the temperature in strictly defined areas of the body with strictly defined pathologies, for example, to measure the temperature of the foot in case of vascular complications of diabetes mellitus. Such thermometers also cannot be used to measure local temperature on an arbitrary part of the body.

3. Pyrometer (for example, PCE-FIT10 - www.industrial-needs.com/manual/manual-pce-FIT10.pdf) - a device for non-contact temperature measurement. The principle of operation is based on measuring the thermal radiation power of an object mainly in the ranges of infrared radiation. Pyrometers are used to remotely determine the temperature of objects. Pyrometers are divided into three main groups:

- brightness (optical) and color (multispectral, spectral ratios). Operating range - starting from hundreds of degrees Celsius and above (for example, the optical pyrometer OPPIR-09 - http://window.edu.ru/resource/935/28935/files/tsurel61.pdf, color SPECTROPIR 11M - http: // pribor -neva.ru/katalog/pyro/spektropir.htm); therefore, they are not intended to work with biological objects;

- radiation - receive infrared radiation with an infrared sensor and estimate the temperature using a converted indicator of the power of thermal radiation. The range of measured temperatures is quite wide (for example, AKIP 9301 - www.mpp-nn.ru/pdf/akip-9301.9302.pdf), can be used to measure the temperature of biological objects, including person.

An important parameter of the pyrometer is the indicator of sight. The PV sighting index is the ratio of the diameter D of the sighting spot to the distance L between the pyrometer and the object: PV = D / L. The spot of sighting is that part of the examined surface from which thermal radiation enters the infrared sensor of the pyrometer registering this radiation.

The indicator of sighting is recorded as a ratio: 1:30, 1:50, 1: 100, etc. The smaller the PV, the smaller the subject may be. For the same object, a pyrometer with a smaller PV allows measurements to be taken from a greater distance. However, for small PV, the radiation power perceived by the pyrometer is very small.

In the case when the diameter of the spot of sight is comparable to the size of the working surface of the infrared sensor of the pyrometer that directly detects thermal radiation, and is small in comparison with the size of the surface to be examined, and the distance between the infrared sensor and the surface of interest is small, the spot of sight of the pyrometer can be conventionally represented as a point. In this application, the term “temperature measuring point” is used throughout this text in that sense.

Pyrometers have the following advantages:

- non-contact nature of the measurement. Allows without physical contact to determine the temperature of the object, without introducing additional distortions at a great distance (meters, tens of meters);

- speed of measuring the temperature of the object. The pyrometer measures the temperature almost instantly.

However, pyrometers cannot be used in the framework of the invention in standard methods for their use for the following reasons:

- the impossibility of high accuracy of pointing to a point for measuring temperature, since the directivity pattern of the infrared sensor of the pyrometer is an expanding cone, as a result (depending on the distance to the object), the pyrometer measures the average temperature in a circular region with a diameter from a few centimeters to tens of centimeters. Also, pyrometers do not allow precise control of the angle of inclination and the distance to the measured object, which also makes it impossible to highlight a specific location of the point for measuring temperature on the human body. The laser designator used to eliminate this drawback is optimal for use in technology, but is not applicable in medicine because of the potential for negative effects, including on the retina of the eye;

- pyrometers do not allow to build a thermogram, which means it is impossible to distinguish the localization of the thermal signs of diseases, including calculate the area of zones with abnormal temperature.

4. The thermal imager is the most advanced device for monitoring the temperature distribution of the investigated surface using an array of infrared-sensitive elements that record the thermal (infrared) radiation of an object. The temperature distribution is displayed on the display (or in memory) of the thermal imager as a color field (thermogram), where a certain color corresponds to a certain temperature. As a rule, the display shows the temperature range of the surface visible in the lens. The typical resolution of modern thermal imagers is from 0.01 to 0.1 ° C. In some models of thermal imagers, information is recorded in the device’s memory and can be read through the computer connection interface. Such thermal imagers are usually used in conjunction with a laptop or personal computer and software that allows you to receive data from the thermal imager in real time. For example, the MobIR M8 thermograph (http://www.dias-infrared.com/pdf/mobirm8_eng.pdf) includes a matrix of thermosensitive elements, a video camera, a liquid crystal display, a computer, a memory card and makes it possible to automatically determine the maximum / minimum temperature by field, display of the maximum, minimum and average temperature, linear profile, isotherm, histogram.

In medicine, thermal imagers have found application in the diagnosis of a number of inflammatory, vascular and oncological diseases (for example, breast cancer - Lawson RN Implications of surface temperatures in the diagnosis of breast cancers // Can Med Ass J 1956, 75: 309-310 and many others .).

Thermal imagers have the following advantages:

- building a two-dimensional thermogram of the body region, rather than obtaining a temperature measurement at a point, allows you to quickly and simultaneously evaluate the condition of the studied object and, for example, highlight the thermal signs of the disease;

- temperature measurement speed - the thermal imager measures the temperature according to the radiation principle and builds a thermogram almost instantly;

- the non-contact nature of the measurement - allows you to determine the temperature of the object without physical contact without introducing additional distortions during the examination at a large distance (meters);

- some models allow at the time of measurement to superimpose the obtained thermogram on the photograph of the object.

However, thermal imagers have significant disadvantages that do not allow their effective use in the framework of the invention:

- the inability to ensure accurate repeatability of measurements carried out periodically, and, therefore, the inability to automatically compare thermograms for monitoring. According to the conditions of a thermal imaging examination, the patient should be in a comfortable relaxed position, which is incompatible with rigid fixation of the patient's position, providing the same orientation of the body parts in front of the thermal imager lens for accurate repeatability of measurements. Each time the patient will be in a new position each time (turned, shifted). In addition, the processes of respiration, palpitations, intestinal motility can introduce distortions, which also lead to the inability to combine and automatically interpret repeated thermograms;

- two types of thermal radiation are essential for measuring the temperature of an object - intrinsic and reflected. Information about the temperature of an object is carried only by its own radiation, which propagates along the normal (perpendicular) to each point on its surface; the reflected radiation carries information about the ambient temperature and only introduces distortions in the value of the true temperature of the object. The greater the deviation from the normal, the greater the surface area with which the reflected radiation comes in, the greater the measurement error. During a thermal imaging examination of the surface of the human body, this error is aggravated by the complexity of the relief, which leads to different mutual re-reflection at different angles of orientation of the thermal imager, especially in areas of natural recesses (navel, interdigital spaces, etc.) and adjacent parts of the body;

- conducting a thermal imaging examination is subject to a number of conditions - in addition to maximally identifying the posture and position in front of the imager from session to session, it is necessary to maintain a stable temperature in the room, the absence of air flow and a number of other requirements (Hooshang Hooshmand, Masood Hashmi, Phillips Eric M. Infrared Thermal Imaging As A Tool In Pain Management - An 11 Year Study, Part I of II // Thermology international. - 11/2 (2001)). The combination of these requirements with varying degrees of standardization can be maintained only in specialized institutions, and therefore the use of thermal imagers, unlike the use of blood pressure monitors, cardiac monitors and glucometers, is impossible at home.

Also restrictions on the use of thermographs are:

- the impossibility of examining body parts having a complex surface topography (protrusions with negative angles, troughs, etc.), since the areas of interest can be geometrically overlapped by relief elements;

- the impossibility of measuring areas covered with hair, because hair shields thermal radiation;

- the high cost of the thermal imager and the need for regular maintenance.

The disadvantage of thermal imaging methods for diagnosis and monitoring is that the pathological process is studied by the temperature field displayed on the monitor screen, which the specialist conducting the examination only associatively associates with the examined area and evaluates it subjectively to a large extent based on personal experience. The experience of a specialist includes both formalized and non-formalized components. The analysis and interpretation of thermograms relies to a greater extent on the non-formalized component of the specialist’s experience, since in the case of analyzing the image of the temperature field, including a large number of heterogeneous interconnected graphic elements, a holistic perception of this image is carried out, which allows extracting diagnostic information in the context of clinical experience and specialist knowledge. “The formalization of medical experience is still at a very low level” (I. M. Gelfand and others. Essays on the joint work of mathematicians and doctors. M., 2011). As a result of this, today thermography and obtained thermograms are largely subjectively interpreted, therefore the method is complex and expensive and is carried out only by specially trained specialists in medical and preventive institutions.

Thermal imaging with high sensitivity has a low specificity. For example, when examined for breast cancer, infrared thermography has a sensitivity of 97% and specificity of only 44% (Arora N, Martins D, Ruggerio D, et al .: Effectiveness of a noninvasive digital infrared thermal imaging system in the detection of breast cancer. // Am J Surg 196 (4): 523-6, 2008). As a result of this, and also because of absolute safety, infrared thermography is not optimal for diagnosis, but is ideally suited for monitoring a wide range of diseases (inflammatory, neoplastic, vascular, degenerative) with a previously established diagnosis.

The existing attempts at partially automated thermal imaging diagnostics (but not monitoring) are based on a comparison of thermograms of patients with an average norm from the accumulated database. However, this approach is not applicable to the monitoring of diseases of a particular patient. Comparison of the skin temperature of a particular person with a certain average norm is not correct, since the temperature of the skin varies in a very wide range (in a healthy person from about 37 ° C to 20 ° C), and its distribution individually on the surface of the body, and depends on very many factors (Features of thermoregulation, the location of subcutaneous vessels, the thickness of subcutaneous fat, etc.). To monitor the condition, it is important to compare the thermograms of just one person at different points in time, and only such a comparison gives information about the dynamics of an individual pathological process. In addition, the implementation of correct monitoring based on the comparison of thermograms using a standard thermograph is feasible only if the following conditions are strictly met: registration of the temperature field of the same object under the same conditions at different points in time, followed by comparison of the obtained thermograms in the same temperature range, which is practically impossible . In addition, when using thermal imagers, it is practically impossible to verify with the necessary accuracy the same distance and angle between the thermal imager and the object of examination during repeated studies. This is compounded by the fact that the human body has a very complex surface topography. And if a person does not take exactly the same position of the examined body area relative to the thermal imager lens during each session, which is almost impossible, the thermograms are difficult to compare, and automatic analysis becomes impossible due to the known incorrectness of the obtained thermograms.

Thus, there is a need to develop methods and devices that can, based on measurements of human body temperature and thermograms, carry out individual monitoring at home (outside medical institutions and / or without the participation of a specialist), i.e. automatically (using a computer program) give conclusions about the dynamics of pathological processes, assess the effectiveness of treatment, recommendations to the user.

The closest in technical essence and the achieved result to the proposed method for monitoring diseases is a method for displaying the temperature field of a biological object, protected by patent RU 2452925 C1, cl. G01J 5/48; G01K 1/00; A61B 5/00, publ. 06/10/2012, adopted for the closest analogue (prototype).

The prototype method includes entering into the computer database the image of the examined area of the body of the biological object, which is displayed on the computer monitor, while the temperature measurement points on the examined area of the object are displayed on the image of the object on the monitor screen and after measuring and processing the measurement results in the computer, the temperature field image a computer program is formed on the image of the examined area of the object. The examined area is photographed with a camera, a photograph or a model image of the body area is entered into the computer base and displayed on a computer screen, the temperature of the examined area is measured mainly with a thermometer or infrared pyrometer.

A common feature with the claimed method of disease monitoring is fixing and displaying on the monitor screen the temperature values of the measurement points and the temperature field (thermogram) superimposed on the image of the examined area of the body, previously entered into the computer's memory, and measuring the temperature on the examined area only at points corresponding to the points initially superimposed on the image, which improves the accuracy of diagnostic measures. However, the prototype method is insufficient to monitor diseases for the following reasons:

- despite the fact that the prototype patent states: “The present invention ... may find application in medical practice for diagnosing diseases and for controlling the dynamics of a disease during treatment” (page 1, paragraph 1), neither in text nor in illustrative material the patent does not justify the technical feasibility of implementing the method described therein for the needs of disease monitoring, the implementation of the method for the purpose of monitoring the dynamics of diseases in the patent is not disclosed;

- does not contain information on the procedure for the automatic implementation of monitoring, i.e. software (using a computer program);

- does not contain a description of the conditions, without which the comparison of thermograms by software becomes correct or incorrect (such conditions are disclosed below in the description of the claimed invention);

- as a means of measuring temperature, it recommends the use of pyrometers or infrared thermometers ("It is advisable to measure the temperature with an infrared thermometer or infrared pyrometer" - page 5, paragraph 5 of the prototype patent). However, due to the previously listed drawbacks, neither pyrometers nor thermometers of previously known structures and in previously known methods of their use can be used to implement the claimed invention. In particular, these devices do not provide the necessary degree of unification of the procedure for repeated temperature measurements during measurements at many points in the body region. Pyrometers, infrared thermometers and thermal imagers with the standard method of their application do not prevent the influence of air flows on the skin surface temperature in the process of non-contact measurement, and contact thermometers and temperature sensors during contact measurement allow direct contact of the thermally sensitive element with the skin surface, which, in both cases, gives rise to additional errors.

Thus, the procedure for displaying the temperature field described in this patent allows one to obtain a thermogram superimposed on a photo image or model of a part of the patient’s body, containing many interconnected elements that are heterogeneous in a complex way (anatomical details, temperature values, temperature transitions) and sufficient for the diagnosis of the disease by a specialist precisely in field of thermography, integrally perceiving a thermogram and extracting the diagnostic information contained in it in accordance with its inicheskim experience. However, analysis of thermograms is impossible for the user without special education, which requires automatic (software) extraction of diagnostic information in the form of simple and generally accessible quantitative and textual indicators of the course of the disease.

The ability to build thermograms is an important, but not necessary element of the claimed invention. The color perception of the image is a subjective process, the number of perceived tones varies depending on age, gender, etc. In general, the quality of color perception decreases with age. In addition, various kinds of aberrations of color perception are frequent, accompanied by a sharp distortion of the perception of colors (color blindness and a number of other diseases that are hereditary or accompanying some diseases of the brain).

Analysis of temperature gradients according to the results of measuring the temperature of points without building thermograms gives important information in the claimed invention, while the construction and analysis of thermograms allows you to get additional, but also significant information.

The implementation of the prototype method also requires the presence and simultaneous use of a large number of technical means: a camera, computer, monitor screen, infrared thermometer or pyrometer, which significantly complicates its practical use at home.

The objective of the invention is to provide a method for monitoring diseases and a device for its implementation, which allows you to automatically monitor the dynamics of the disease, evaluate the effectiveness of therapy according to the thermal signs of the evolution of the disease, automatically make conclusions and recommendations to the user directly on the device’s display and, at the request of the user, transmit the measurement results to interested persons (including doctor) through communication channels.

At the same time, the method and device allow implementing control mechanisms for the treatment of diseases at home without visiting a doctor and performing expensive tests.

The technical result achieved by solving the problem lies in increasing the accuracy of monitoring the disease without the participation of a specialist, simplifying and reducing the cost of obtaining information about the course of the pathological process and conclusions about the effectiveness of treatment without the participation of a specialist.

The result in the claimed method for monitoring diseases, which includes preliminary storing in the computer memory a photo image or a 2D or 3D model of the examined area of the patient’s body, displaying on the computer display the indicated image with points indicated on it for measuring temperature, measuring the temperature at such points and forming the image on the examined the area of the temperature measurement results, is achieved by the fact that the input into the computer memory of the image of the examined area with the indicated on it points for measuring temperature are carried out once; temperature measurement on the human body at the corresponding points indicated on the image is carried out repeatedly during the monitoring period with temperature values stored in the computer memory; compare the temperature values obtained at the same points during different monitoring sessions, and based on this comparison, form the monitoring results; they use a device that includes a memory unit, a display, a camera, an infrared sensor, means for providing the specified distance and angle between the examined area of the human body and the infrared sensor, control buttons, a power source, a communication module, and a computer connected to the memory unit , display, infrared sensor, camera, wireless unit, control buttons and power source.

Particular cases of the implementation of the claimed method involve the designation of points for measuring temperature in the image of the examined area with an orientation to the anatomical landmarks inherent in this area in an amount minimally sufficient to monitor any pathological process in this area (the resulting image with the indicated points is hereinafter referred to for brevity) "template"); points for measuring temperature indicated on the image of the examined area are obtained from the computer memory; points for measuring temperature are indicated on the image of the examined area manually; temperature measurement at fixed points of the examined area is carried out in accordance with the unification of the distance and angle between the examined area of the human body and the infrared sensor, sufficient to ensure repeatability of consecutive temperature measurements at the same points on the surface of the examined area of the human body throughout the monitoring period; the image of the examined area is made in the form of a photograph; the image of the examined area is made in the form of a model 2D (two-dimensional) or 3D (three-dimensional) image, the monitoring results are formed in the form of a text message; monitoring results form in the form of a graphic message; monitoring results form in the form of an audio message; the computer is made, for example, on standard SoC class platforms on the ARMv9 core, or similar with similar performance and power consumption, for example, ARM architecture, x86; standard platforms, such as, for example, Android 2.3, Qt, Windows Mobile, or similar, which ensure the effective functioning of the device, are used as basic software; an additional memory block is made, for example, on a flash card that can be disabled for subsequent use of the data stored in it on a personal computer; a memory block is organized as a relational database or a flat file storage; as a relational database can be used, for example, SQLite; the screen is made, for example, touch sensitive to touch; the screen sensor is made on a resistive or capacitive matrix; the screen is made with a diagonal, for example, 3.5 ”, with a resolution of, for example, 320 × 240 pixels, with a color depth of, for example, RGB 16 bits; an infrared sensor is made, for example, based on a standard infrared sensor with a maximum sensitivity in the temperature range of biological objects of 20-45 ° C; an infrared sensor is made, for example, based on the MLX90614 sensor; at least two holes are made in the housing of the disease monitoring device, with an infrared sensor installed in at least one of said holes and a camera lens mounted in the other of said holes; temperature measurement is carried out at several points in the dot pattern at the same time using more than one infrared sensor; the device is additionally equipped with a remote module in the housing of at least one infrared sensor, equipped with a means of providing a predetermined distance and angle between the examined area of the human body and the infrared sensor and connected to the device for monitoring diseases using a flexible cable, for example, 1.5 m long, while in the case of the device for monitoring diseases, a winding mechanism of a flexible cable with a return spring is made; the remote module can be connected to a device for monitoring diseases using wireless communications, while the remote module is made in conjunction with a transmitting unit and a battery pack, while a receiving unit is installed in the case of the device for monitoring diseases; the wireless communication unit is made using standard solutions, for example, such as, for example, GPRS, IEEE 802.11, 802.15, etc .; the power source is battery; the battery power supply is, for example, in the form of a Li-ion or Ni-Cd battery; means for providing a predetermined distance and angle between the examined region of the human body and the infrared sensor is made on one of the ends of the body, for example, in the form of a cylindrical protrusion with rounded edges from an elastic, biologically neutral material with a minimum coefficient of thermal conductivity; means for providing a predetermined distance and angle between the examined region of the human body and the infrared sensor is made in the form of a protrusion of, for example, processed ABS plastic; the protrusion is made, for example, of hypoallergenic plastic - of polyurethane; a hollow metal truncated cone with open ends (hereinafter referred to as the “bell”) is installed inside the protrusion, while the infrared sensor is built into the narrow top of the cone; the diameter of the cylindrical protrusion should be sufficient to ensure accurate visual positioning at the temperature measuring point and providing a sufficient sighting index for the examination, for example 8 mm; the body of the device for monitoring diseases is made of plastic; The device for monitoring diseases contains a memory unit and a device for connecting an additional memory unit (flash memory), the device for monitoring diseases has the function of changing the buttons for the right and left hands.

The result is also achieved by using a device for monitoring diseases, containing a computer, a memory unit, a screen, a camera, an infrared sensor, a computer, a memory unit, a screen and a camera made in one housing, and there is an additional means of providing a predetermined distance and angle between the examined area of the human body and infrared sensor, control buttons, power source, communication module, while the computer is connected to a memory unit, a screen, an infrared sensor, a camera, a wireless unit, buttons and control and power supply.

Particular cases of the implementation of the claimed device involve the execution of a computer, for example, on standard SoC class platforms on the ARMv9 core, or similar with similar performance and power consumption, for example, ARM architecture, x86, or any other; as the base software, standard platforms are used, such as, for example, Android 2.3, Qt, Windows Mobile, or similar, ensuring the functioning of the device; the memory unit is made disconnectable on the flash memory for subsequent use of the data stored in it on a personal computer; a memory block is organized as a relational database or a flat file storage; as a relational database can be used, for example, SQLite; the screen is made, for example, touch, sensitive to pressure, while the screen sensor is made both on the resistive matrix and on the capacitive; the screen is made with a diagonal, for example, 3.5 ”, with a resolution of, for example, 320 × 240 pixels with a color depth of, for example, RGB 16 bits; an infrared sensor is made, for example, based on a standard infrared sensor with a maximum sensitivity in the temperature range of biological objects of 20-45 ° C; an infrared sensor is made, for example, based on the MLX90614 sensor; at least two openings are made in the housing, with an infrared sensor installed in at least one of said openings, and a camera lens mounted in the other of said openings; the device is additionally equipped with a remote module connected to a device for monitoring diseases using a flexible cable, for example, 1.5 m long, while the housing has a flexible cable winding mechanism with a return spring; a remote module connected to a device for monitoring diseases using wireless communications, wherein the module is made in conjunction with a transmitting unit and a battery pack, and a receiving unit is installed in the housing; the wireless communication unit is made using standard solutions, for example, such as GPRS, 1, 802.15, and others; the power source is battery; the battery power supply is, for example, in the form of a Li-ion or Ni-Cd battery; means for providing a predetermined distance and angle between the examined region of the human body and the infrared sensor is made on one of the ends of the body, for example, in the form of a cylindrical protrusion with rounded edges from an elastic, biologically neutral material with a minimum coefficient of thermal conductivity; means for providing a predetermined distance and angle between the examined region of the human body and the infrared sensor is made in the form of a protrusion of, for example, processed ABS plastic; the protrusion is made of hypoallergenic plastic, for example, polyurethane; a bell is installed inside the protrusion, while the infrared sensor is built into the narrow top of the cone; the diameter of the cylindrical protrusion should be sufficient to ensure accurate visual positioning at the temperature measurement point and provide a sufficient sighting index for the examination, for example, 8 mm; the case is made of plastic; the device comprises a storage medium and a device for connecting a storage medium; The device has the function of changing the buttons for the right and left hands.

The invention is illustrated by the following graphic materials.

Figure 1 presents the logical implementation of the method of monitoring diseases.

Figure 2 presents a general view of a portable device for monitoring diseases (A - view from the front side, B - view from the back side, C - view from above, D - view from below, E - view from the right, F - view from the left, G - view from the front side with rotation relative to the longitudinal axis, N - view from the front side with rotation and inclination relative to the longitudinal axis). The numerals in figures 2-9 are commented on.

Figure 3 presents an image of a General view of a device for monitoring diseases with internal components.

Figure 4 presents a block diagram of the functioning of the device for monitoring diseases.

Figure 5 presents the image of the section of the means to ensure the specified distance and angle between the examined area of the human body and the infrared sensor as part of a device for monitoring diseases.

Figure 6 image of a device for monitoring diseases with an external module.

Figure 7 presents an image of a possible embodiment of the assembly of the housing and landing elements of the device for monitoring diseases.

On Fig presents a General view of a portable device for monitoring diseases containing more than one infrared sensor.

Figure 9 presents the image of the remote module containing more than one infrared sensor.

Figure 10 presents the displayed on the screen of the device for monitoring diseases, a two-dimensional image of the examined area on the monitor screen.

11 shows a three-dimensional image of the examined area displayed on the screen of the monitor on the screen of the device for monitoring diseases.

On Fig presents the displayed on the screen of the device for monitoring diseases two-dimensional image of the examined area with points of temperature measurement.

On Fig presents the displayed on the screen of the device for monitoring diseases three-dimensional image of the examined area with points of temperature measurement.

On Fig presents the displayed on the screen of the device for monitoring diseases, a two-dimensional image of the examined area with points of temperature and temperature values corresponding to the specified points.

On Fig presents the displayed on the screen of the device for monitoring diseases, a three-dimensional image of the examined area with points for measuring temperature and temperature values corresponding to these points.

On Fig presents the displayed on the screen of the device for monitoring diseases a two-dimensional image of the examined area with points for measuring temperature and temperature values corresponding to the indicated points, a thermogram based on the temperatures corresponding to the indicated points, as well as the results of the first examination.

On Fig presents a three-dimensional image displayed on the screen of the device for monitoring diseases, the examined area with points for measuring temperature and temperature values corresponding to the indicated points, a thermogram based on the temperatures corresponding to the indicated points, as well as the results of the first examination.

On Fig presents the displayed on the screen of the device for monitoring diseases, the results of studies with monitoring results.

On Fig presents a variant of the use of the device by the patient - the device in the hand, how to properly position it in the left and right hand.

Figures 20-56 illustrate specific examples of the application of the claimed method and device and are explained in the corresponding examples hereinafter.

Structurally portable device for monitoring diseases in figure 2-9 contains:

1 - computer;

2 - memory block;

3 - screen;

4 - infrared sensor;

5 - camera;

6 - wireless communication unit;

7 - control buttons (for example, on / off button, photo image acquisition button, temperature acquisition button, touch screen button);

8 - power source;

9 - a means of providing a predetermined distance and angle between the examined area of the human body and the infrared sensor;

10 - case.

Computer 1, memory unit 2, screen 3, infrared sensor 4, camera 5, wireless unit 6, control buttons 7, power supply 8 and means for ensuring a predetermined distance and angle between the examined area of the human body and infrared sensor 9 are installed in one housing 10 .

Computer 1 is connected to a memory unit 2, a screen 3, an infrared sensor 4, a camera 5, a wireless unit 6, control buttons 7 and a power source 8.

Computer 1 can be executed, for example, on standard SoC class platforms on the ARMv9 core, or similar with similar performance and power consumption of the ARM architecture, x86, or any other.

As the basic software, standard platforms can be used, for example, such as Android 2.3, Qt, Windows Mobile, or similar, ensuring the functioning of the device.

The memory unit 2 can be executed, for example, on flash memory and can be disabled for later use of the data stored in it on a personal computer.

The memory block 2 can be organized as a relational database or, for example, a flat file storage. As a relational database, for example, SQLite can be used.

Screen 3 can be made touch sensitive to touch. In this case, the sensor can be performed both on a resistive matrix and on a capacitive one.

Screen size 3 can be selected based on ergonomic requirements, for example, to comfortably lie in the hand. The diagonal of the screen 3 can be, for example, 3.5 ”, and the resolution can be, for example, 320 × 240 pixels with a color depth of, for example, RGB 16 bits.

The infrared sensor 4 can be made on the basis of standard sensitive infrared sensors having a maximum sensitivity in the temperature range of biological objects of 20-45 ° C. As such, for example, the infrared sensor MLX90614 can be used.

The device for monitoring diseases can contain several infrared sensors 4, which can be located on one or at different ends of the housing 10. In this case, additional holes can be made in the housing 10, the number of which will correspond to the number of sensors 4.

For example, two holes can be made in the housing 10, for example, an infrared sensor 4 can be installed in one of these holes, and a camera lens 5 is mounted in the other of these holes.

An additional remote module with an infrared sensor 4 can be connected to the device using either a flexible cable or wireless communication.

In the case of using a flexible cable, made, for example, with a length of 1.5 m, a mechanism for winding a flexible cable with a return spring can be made in the housing 10.

In the case of using wireless communication, a remote module with an infrared sensor 4 can be implemented in conjunction with a transmitting unit and a battery pack 8, in which case a receiving unit must be installed in the housing 10.

The wireless communication unit 6 provides wireless transmission of data on the measurement results from the patient to interested parties or to a database for subsequent analysis. The wireless communication unit 6 can be performed using standard solutions, such as, for example, GPRS, 802.11, 802.15, etc.

The power source 8 is made, for example, battery to ensure the possibility of use in the field, at home and to reduce the risk of injury by electricity to the patient. As such a power source, for example, a Li-ion or Ni-Cd battery can be used.

Means for providing the specified distance and angle between the examined region of the human body and the infrared sensor 9 can be performed on one of the ends of the housing 10, for example, in the form of a cylindrical protrusion with rounded edges from an elastic, biologically neutral material with a minimum coefficient of thermal conductivity, for example, from treated ABS plastic. The means of ensuring the specified distance and angle between the examined region of the human body and the infrared sensor 9 can also be performed without a protrusion, in the form of a structural arrangement of the infrared sensor located inside the device and remote from the outer border of the body.

The protrusion can be made of hypoallergenic plastic, for example, polyurethane, to ensure that there is no negative reaction from the human body and no or minimal effect on the local skin temperature during short-term contact, which is achieved using materials with a minimum coefficient of thermal conductivity.

A socket - a hollow metal truncated cone with open ends can be installed inside the protrusion, while the infrared sensor 4 is built into the narrow top of the cone. The diameter of the cylindrical protrusion must be sufficient to ensure accurate visual positioning at the temperature measurement point and provide a sufficient sighting index for the examination, for example, 8 mm.

The housing 10 can be made, for example, of plastic, providing sufficient mechanical strength, as well as ease of cleaning with constant use. The material of the housing 9 must be resistant to cleaning and disinfection.

A device for monitoring diseases may contain a storage medium and a device for connecting an additional storage medium.

Disease monitoring devices can be manufactured using standard technologies. The main elements of the device, such as a computer 1, a memory unit 2, a screen 3, an infrared sensor 4, a camera 5, a wireless communication unit 6, are performed, for example, on one printed circuit board, which ensures the small dimensions of the device and low power consumption. The housing 10 is made, for example, by injection molding or vacuum casting. A hollow truncated open (focusing) cone-bell at both ends, which is part of the means for providing the specified distance and angle between the examined region of the human body and the infrared sensor 9, is made of metal, for example, by stamping.

In the case 10, the construction components are installed so that spurious thermal radiation (heating) of the components does not affect the accuracy of temperature measurements by the infrared sensor 4. One of the placement options is the location of the parts that are most heated during operation (computer 1, memory unit 2, camera 5, the power source 8) at a maximum distance from the infrared sensor 4. For example, an infrared sensor 4 and a camera 5 are placed at opposite ends or on opposite walls of the housing 10.

To facilitate the assembly of the device can be used for mounting electronic components in the housing 10 disposable support, refilled after installation. To fix the components of the housing 10 relative to each other, disposable latches along the perimeter of the device or other fixing methods can be used.

The dimensions of the device are made in such a way that it fits comfortably in the user's hand (does not go beyond the palm of the hand with fingers extended) and can be held without using a second hand.

A device for monitoring diseases operates as follows, the technical operation algorithm is described below.

Button 7 allows you to select one of several control functions through the use of a menu with a set of functions. By pressing the control button 7 corresponding to the camera, the camera 5 registers the image and transfers it to the computer 1; computer 1 saves the registered image in memory unit 2 and displays it on screen 3. Instead of registering the image with camera 5, the computer can extract a 2D or 3D model (finished image) from memory unit 2 and display it on screen 3. By pressing the control button 7 corresponding to infrared sensor, infrared sensor 4 records the temperature and transfers it to computer 1; the computer saves the registered temperature in the memory unit 2 and displays it on the screen 3. When a sufficient number of measurements (according to the program) is reached, the temperatures in the memory unit 2, the computer 1 program constructs a thermogram and superimposes it on the previously registered image from the camera 5 stored in the unit memory 2, and displays the result on screen 3. By pressing the control button 7 corresponding to wireless communication, computer 1 receives registered images, thermograms, and values of measured temperatures p from the memory unit 2, and transmits them to the wireless communication unit 6 for subsequent broadcast to interested parties. To facilitate the use of the device when operating it in the right or left hand, it may have the function of reassigning the functions of the buttons. For example, the button located to the left of the pyrometer lens may have the function of obtaining the temperature of the infrared sensor or registering the image from the camera.

The device can additionally be equipped with several infrared sensors located sequentially on one of the ends of the housing, while each of the sensors can be equipped with a means of providing a given angle and distance, or several sensors are installed in one tool. In the second case, the means for providing the given angle and distance can be a truncated cone, open at both ends, but having an ellipse shape in cross section. Such a constructive solution allows temperature measurements at several points at the same time (for example, at the touch of a button) provided that the distances between the points of the template coincide with the distance between infrared sensors, which can greatly simplify self-examination or the work of specialists with the device when examining body parts with a relatively even geometric surface, such as breast or back.

The remote module with infrared sensors, optionally included in the device and connected to it via wired or wireless communication, greatly facilitates the use of the method and device both by the patient and the assistant when examining areas such as the head, back, face. The convenience of operating the remote module may consist in the possibility of taking measurements without losing eye contact with the device’s screen and, accordingly, increasing the accuracy of positioning of infrared sensors relative to the skin, as well as the possibility of taking measurements in hidden cavities (for example, ears or internal cavities during surgical operations), in areas with hair, where there are high requirements for the dimensions of the measuring part. The ease of use of the remote module may also consist in the possibility of the assistant taking measurements of those areas that the patient himself cannot examine, for example, backs. An additional advantage is the ability to disinfect the remote module that has direct contact with the patient, regardless of the main device, as well as the ability to completely replace the remote module without replacing the main device.

The device can optionally be equipped with a module for connecting to an external display (Fig. 20), made, for example, according to the HDMI standard. The use of an external display with a significantly larger diagonal than that of the device itself facilitates the visualization of the template, anatomical signs and the results of monitoring (for example, a thermogram), which greatly facilitates the positioning of infrared sensors on the measured points, and in case of use by medical personnel it allows to clearly explain to the patient how use the claimed device. The large external display also makes the use of the device accessible for visually impaired people who are unable for health reasons to view images on the small screen of the device.

The presence of a microphone and speaker allows you to implement the function of sound notification of the patient about the monitoring results, which facilitates the perception of information by hearing impaired people, and also allows you to establish audio communication with a consultant provided by the wireless unit (Fig. 21). Due to this, the consultant has the opportunity to assess the correct use of the device by the patient, determine the correct use of the template, conduct the necessary training, and also quickly monitor the patient's condition.

A plug-in memory module made, for example, as SD CARD, which is a possible component of the device, allows you to transfer the measurement database to a computer, where there is the possibility of a more detailed analysis of the monitoring results, comparison with the results of other patients. Additionally, a plug-in memory module can be used to transfer updated templates to the device, as well as to update its software. The same function can provide a communication module with an external computer (Fig.22) without using a plug-in memory module.

The function of adjusting the device for the left and right hand (mirror change of button assignments) makes it possible to conveniently operate in the left or right hand for right-handed and left-handed people, as well as to monitor areas more conveniently accessed by either the left or right hand (for example, left or right collarbone or left or right elbow joint).

The claimed method for monitoring diseases using the proposed device is as follows, the following describes the basic sequence of actions of the patient or medical staff.

At the first examination (self-examination) session, the image of the examined area is received from the camera 5 and displayed on the screen 3 in the form of a photograph - Figs. 23 and 24 for examination / self-examination, respectively. Alternatively, at the user's request, 2D or 3D models of the human body can be used as the image of the examined area, retrieved from the device’s memory on the screen 3. Using the control buttons 7, the image is shifted, rotated and scaled on the screen 3. It is fixed on the image of the examined area points for measuring temperature, for example, by overlaying a ready-made set of points (from the device’s memory) present in the program, or form this template sequentially manually (Figs. 25 and 26). When manually placing the points, the user is guided by examples stored in the memory of computer 1 (either extracted from an external source, for example, from a user’s manual), or, at the request of the user, doctor’s recommendations, or via communication channels using telemedicine technologies. Images of the examined area with points for measuring temperature are entered into memory 2 of computer 1 once to obtain a template stored in memory 2 of computer 1 for subsequent use for the entire monitoring period. During repeated monitoring sessions, the saved template is retrieved from the device’s memory.

In some cases, a significant change in the appearance or size of the examined surface and the resultant accuracy of measurements of the mismatch between the image of the surface and the real surface (for example, decreasing edema or healing wound) that is essential for this purpose, it becomes necessary to create, save and use a new template (new image with points on it for measuring temperature).

Next, the temperature of the examined area is measured at each point using an infrared sensor 4 (Figs. 27 and 28) and information is obtained in the form of temperature data at each point (Figs. 29 and 30). Temperature measurement in points according to the pattern on the examined area is carried out repeatedly during the time interval selected by the user. Using the means to ensure the specified distance and angle between the examined area of the human body and the infrared sensor 9, made, for example, in the form of a protrusion of biologically neutral material around the hole in which the infrared sensor 4 is installed, the temperature is measured at the points of the examined area with the maximum unification of the distance and the angle of inclination between the surface of the examined area and the temperature sensor. The measurement results are stored in the device memory and processed with the issuance of numerical indices, sound and text messages. Also, according to the measurement results, a thermogram is obtained on the image of the examined area (Figs. 31 and 32) by a predetermined method and stored in memory 2 of computer 1. The accuracy of constructing a thermogram depends on the number of points and the distance between them: the more points in the selected area and less the distance between them, the higher the accuracy of building a thermogram.

Based on the results of the first examination session, some numerical indices are automatically determined (for example, the maximum temperature difference between the points of the examined area, the area of the hypo- and hyperthermia zones of the thermogram of the examined area, etc.; textual conclusions automatically reflecting the results of the analysis, for example, “Maximum thermal asymmetry 0.8 ° C The area of hyperthermia is 26.5% "). However, the independent value of the data of the first examination session in accordance with the claimed method and device is small due to the known low specificity of the thermography method. These data are of additional importance and only for the specialist, not the average user, and only in conjunction with other clinical / paraclinical data that establish an accurate diagnosis.

At the user's choice, starting from the second examination session, they compare the measurement results (temperature values of the same points of the template obtained with different monitoring sessions and / or thermograms) in automatic mode, analyze in accordance with the laid down algorithms with conclusions on the course of the pathological the process and / or effectiveness of the treatment, as well as with the issuance of numerical indices, text messages, sound messages, thermograms, temperature change graphs to the user.

If desired, the user can transmit the measurement results via communication channels using the wireless unit 6.

Thus, after each session, the user receives information on the device’s display, including numerical indicators, text and sound messages, thermograms, and graphs of temperature changes. Thus, starting from the second session, it is possible to automatically evaluate the course of the pathological process and / or the effectiveness of the treatment by a comparative analysis of the temperature of the points of the template and / or thermograms.

Numerical indicators can be expressed as a set of important indices, including:

- maximum thermal asymmetry in the examined area (maximum detected temperature difference at symmetrical points);

- the maximum difference in temperature in the examined area from the temperature at the point of comparison;

- longitudinal gradient on the extremities (for example, the temperature difference in the upper and lower thirds of the leg), for example, in degrees Celsius;

- zone of hyper- or hypothermia in% of the examined area (the ratio of the number of points with significant, according to the algorithm, increased or lowered temperature to the total number of points in the examined area);

- the difference in temperature values at the same points of the template in previous and subject to analysis measurements;

- other indices.

To increase the clarity on the screen 3 of the device, numerical indicators (as well as text messages) can be presented in different colors: for example, in the case of compliance with the norm - in green, in the case of a slight deviation from the norm - in yellow, and in the case of a significant deviation from the norm - in red. In addition, to increase the clarity, according to the results of calculating numerical indices in dynamics, it is possible to construct graphs reflecting changes in these indices, for example, a graph of the change in the area of a hyperthermia or hypothermia region, a graph of a change in the value of a point or points of maximum or minimum temperature, etc. This allows the patient to understand, for example, which pharmaceutical of several taken during the monitoring period acted on the thermal signs of the disease most effectively.

Text messages in a short and accessible form inform the user about the course of his illness, the effectiveness of the treatment and the recommended measures, for example: “Thermal signs of negative dynamics” or “Thermal signs of positive dynamics. Local exposure is recommended, primarily on the hyperthermia zone. ”

In aggregate, numerical indices, sound and text messages provide the user with basic information, in normal cases sufficient to make decisions without contacting a specialist. To visualize the size, shape and localization of the pathological focus and their changes in time, as well as the exact choice of the place of exposure, thermograms are needed.

Thermograms superimposed on the image or photograph of the examined area reflect the objective localization of the pathological focus, which does not always coincide with the localization of pain and other subjective sensations, which allows the user to make local therapeutic effects more targeted and effective. Also, thermograms display the relative position and shape of the zones of hyper- and hypothermia in the examined area, which is important information during telemedicine consultations. This visualization most clearly and concisely displays the dynamics of the process as a whole.

The first temperature measurement of the points of the template, including with the construction of a thermogram, it allows you to get an automatic analysis regarding the features of the temperature distribution in the examined area. Using the proposed method and device for monitoring diseases ensures the receipt and preservation of two or more temperature values of the same points of the template of the same examined area at different monitoring sessions and their comparison in automatic mode, which increases the accuracy of disease monitoring, simplifies and reduces the cost of information to the user the course of the pathological process and / or the effectiveness of treatment in the form of conclusions and recommendations in ordinary cases without the participation of a specialist.

The claimed method, in contrast to the prototype, discloses the conditions for a unified, repeatedly repeated temperature measurement at the same points of the template for different monitoring sessions on the surface to be examined for the purpose of correctly comparing the temperature values of the points of the template in dynamics, the conditions for comparing the temperature of the points of the template and thermograms with hardware and software, namely, building them on the basis of a once-formed image with a set of points (template) once placed on it, and t kzhe allows to obtain the sequence of the template points temperatures and thermograms that meets the following criteria:

- temperature measurement at all points according to the template and in each measurement session, observing the most unified distances and the angle of the infrared sensor to the examined area of the human body;

- these actions allow you to correctly and automatically compare the obtained temperature values of the points of the template and / or thermograms and automatically make conclusions about the dynamics of the pathological process and / or the effectiveness of treatment, as well as give recommendations to the user.

The device proposed in the framework of the claimed method implements the claimed method as efficiently as possible. It has the advantages of contact thermometers, pyrometers, thermal imagers, while devoid of their disadvantages:

- allows you to accurately position yourself on the measurement point in each series of measurements by means of ensuring the specified distance and angle between the examined area of the human body and the infrared sensor, which ensures compliance with the maximum unified distance and angle of inclination with respect to the examined area of the human body and prevents the influence of air flows on the results measuring the surface temperature of the body with an infrared sensor, and also prevents direct contact of the infrared sensor skin surface, which provides for eliminating the additional errors;

- has a fixed spot spot size, and also provides a low measurement error due to the maximum unification of the distance and the angle of inclination between the infrared sensor and the surface being examined in a series of measurements;

- combines high accuracy of temperature measurement with a high speed of measurement due to the use of the radiation principle, which allows for one session to quickly measure the temperature of the number of points sufficient to identify and observe any pathology that is possible in the study area, including in hard-to-reach areas, for example, covered with hair, behind the ears, in the oral cavity, in the area of contractures, skin folds, contact or close proximity of body parts (interdigital spaces, etc.);

- allows you to take temperature measurements and save in memory the temperature values of the points of the template and / or thermogram necessary for further analysis, while the unification of the measurement procedure by the device provides the ability to use the same template for measuring temperature during repeated examinations and to correctly compare the results of temperature measurements points of the template and / or thermograms made at different times;

- has the ability to implement any algorithms for analyzing the temperature values of the points of the template and / or thermograms and comparing them, as well as displaying thermograms, the results of their comparison, conclusions and recommendations to the user;

- It has small dimensions, mobility, autonomy and manufacturability in production.

The following are examples of specific uses of the claimed method and device for its implementation.

Example 1

Patient K., 29 years old, was referred by a therapist for a consultation with an otorhinolaryngologist. Complained of constant, intense, throbbing pain in the projection area of the left maxillary sinus, aggravated by exposure to cold air, nasal congestion on the left, purulent discharge from the left nasal passage, headache, weakness, and fever up to 37.8 ° C.

The patient associates the onset of the disease with hypothermia. A history of the operation to eliminate the curvature of the nasal septum in 2000. In 2003, treatment for right-sided sinusitis and cysts of the maxillary sinus. 2 weeks ago was treated by a dentist.

When examined by an otorhinolaryngologist, the condition is satisfactory. The nose is of normal shape. The skin of the nose is flesh-colored, normal moisture. Breathing through the right nasal passage is free, through the left - it is difficult. Smell is not changed. Slight hyperemia and slight swelling of the skin in the area of the projection of the left maxillary sinus are noted. Palpation of the nose is painless. Pain on palpation of the region of the projection of the maxillary sinus on the left is revealed.

Anterior rhinoscopy: The vestibule of the nose on the right and left is free. On the right, the nasal mucosa is pink, smooth, moderately moist, the shells are not enlarged, the lower and common nasal passages are free. The nasal septum is in the midline, has no significant curvature. On the left, the nasal mucosa is hyperemic, edematous, the concha is enlarged, an accumulation of purulent secretion is detected in general, more in the middle nasal passage, flowing from under the middle conch.

Posterior rhinoscopy: Hoans and nasopharyngeal arch are free, the mucous membrane of the pharynx and shells is pink, smooth, the posterior ends of the shells do not come out of the choanas, the opener is in the midline. The mouth of the auditory tube is closed.

Clinical blood test: erythrocytes - 4.18 × 10 ¹² / l, Hb - 126 g / l, color, indicator - 0.95, white blood cells - 10.2 × 10 ⁹ / l (young neutrophils - 1%, stab - 3 %, segmented - 70%, lymphocytes - 25%, monocytes - 1%), ESR - 25 mm / h.

X-ray examination: in the maxillary sinus on the left is a horizontal fluid level. The cells of the ethmoid labyrinth are visualized. The frontal sinus is pneumotized.

Based on the anamnesis, examination, and data from additional examination methods, the diagnosis was made: Acute left-sided sinusitis.

The following treatment was prescribed: a vasoconstrictor (Naphazoline - nasal drops), antibiotic therapy (Cefotaxime intramuscularly).

To monitor the dynamics of the inflammatory process, the patient was asked to conduct infrared face thermography every other day in the projection of the maxillary sinuses using the inventive device.

The patient received a face image using the inventive device and manually set the points for measuring temperature on the touch screen using a stylus. The points were placed on the screen at a distance between each other, corresponding to about 1 cm on the face, on the face photo in the area of the projections of the maxillary sinuses and on the nose (Fig. 33).

The patient measured the skin temperature using an external module, looking at the device’s screen. The temperature is measured sequentially by points, the point for measurement is highlighted in red on the display (Fig. 33 is shown by an arrow). The temperature values were obtained at each of the measured points, the thermogram shown in Fig. 34 was automatically constructed. The thermogram shows pronounced thermo-asymmetry and hyperthermia in the region of the left maxillary sinus. The program automatically generated the following conclusion: “Maximum thermal asymmetry of 2.5 ° C. Hyperthermia zone 37.5% ”(note: red letters).

After a day, the patient conducted a second self-examination and received a thermogram shown in Fig. 35. After comparing it with the first values of the temperature measurements, the following conclusion was automatically generated: “The maximum thermal asymmetry is 1.6 ° C. Hyperthermia zone 25%. Thermal attributes of positive dynamics. "

Repeated self-examination gave a thermogram shown in Fig. 36. After comparing it with the previous thermogram, the following conclusion was automatically generated: “The maximum thermal asymmetry is 1.4 ° C. Hyperthermia zone 25%. There are no thermal signs of positive dynamics ”(note: letters are red).

The next day, the patient came to the otorhinolaryngologist for a second appointment. According to the patient, the pain became more moderate, the body temperature decreased to 37.0-37.4 ° C, and weakness decreased. However, nasal congestion on the left and purulent discharge from the left nasal passage remained. The doctor additionally prescribed therapeutic punctures of the maxillary sinus with washing with a solution of furacilin.

After two punctures, the thermogram shown in Fig. 37 was obtained. After comparing it with the previous thermogram, the following conclusion was automatically generated: “The maximum thermal asymmetry is 1.0 ° C. Hyperthermia zone 18.75%. Thermal attributes of positive dynamics ”(note: yellow letters).

Within a week, the patient took antibiotics, and a complete clinical recovery was achieved, which was confirmed by several thermograms, the last of which is presented in Fig. 38, as well as the graph of the dynamics of maximum thermal asymmetry presented in Fig. 39. The program automatically generated the following conclusion: “Maximum thermal asymmetry of 0.4 ° C. Normothermy zone 100%. Thermal attributes of positive dynamics ”(note: green letters).

Example 2

Patient N., 50 years old, has been observed by a rheumatologist for 15 years about osteoarthritis of the left knee joint of post-traumatic origin. According to X-ray examination: narrowing of the joint gap due to destruction of the cartilage, subchondral osteosclerosis, osteophytes, cystic remodeling of the epiphyses of the left knee joint.

Has at home the claimed device for monitoring the condition of the knee joints. During remission, he conducts self-examination of the knee joints 1-2 times a month, in the autumn-winter period - 1 time per week, with exacerbations daily. In the base of the claimed device, a photo image of the knee joints was previously entered, which was obtained using the inventive device after the patient marked the centers of the patella with a marker according to the instructions (Fig. 40).

Using this program, a grid with points for measuring temperature (template) was superimposed on this photo image, while the central points (marked by arrows) were aligned with the centers of the kneecaps (Fig. 41). The first thermogram is shown in Fig. 42. The program automatically generated the following conclusion: “Maximum thermal asymmetry of 0.8 ° C. Hyperthermia zone on the left is 8.3% ”(note: yellow letters).

After inadequate physical exertion for this patient, severe pain in the left knee joint and limitation of mobility, pain on palpation, more pronounced on the outer surface, a feeling of “crunch” when moving in the joint appeared. A self-examination using the inventive device showed a thermogram shown in Fig. 43.

After comparing it with the previous thermogram, the following conclusion was automatically generated: “The maximum thermal asymmetry is 1.8 ° C. Hyperthermia zone on the left 19.4%, on the right 2.7%. Thermal signs of negative dynamics. Local therapeutic effects are recommended mainly in the hyperthermia zone ”(note: red letters). The patient began to apply the treatment that was prescribed to her earlier: anti-inflammatory drugs and chondroprotectors (Diclofenac-Gel locally in the hyperthermia zone, Theraflex and HARPASUL Natysal Forte inside). A self-examination conducted after a week showed the result shown in Fig. 44.

After comparing it with the previous thermogram, the following conclusion was automatically generated: “Maximum thermal asymmetry of 1.4 ° C. Hyperthermia zone on the left is 14%, on the right 2.7%. Thermal signs of positive dynamics. Local exposure is recommended primarily on the hyperthermia zone ”(note: yellow letters).

The patient continued treatment, and another week later a thermogram was obtained, shown in Fig. 45. After comparing it with the previous thermogram, the following conclusion was automatically generated: “The maximum thermal asymmetry is 1.0 ° C. Hyperthermia zone on the left is 11%, on the right 2.7%. Thermal signs of positive dynamics. Local exposure is recommended primarily on the hyperthermia zone ”(note: yellow letters).

The patient continued treatment, and another week later a thermogram was obtained, shown in Fig. 46. After comparing it with the previous thermogram, the following conclusion was automatically generated: “Maximum thermal asymmetry of 0.6 ° C. Hyperthermia zone on the left is 2.8%. Thermal attributes of positive dynamics ”(note: green letters).

Example 3

Patient B., 40 years old, has been suffering from varicose veins of the lower extremities for more than 10 years, more pronounced on the left, which appeared during pregnancy. Clinical diagnosis: Varicose veins of the lower extremities. Chronic venous insufficiency 1-2 degrees. Accepts estrogen-containing contraceptives.

Has at home the claimed device for monitoring the condition of veins of the lower extremities. Usually conducts self-examination of the legs 1-2 times a month. In the base of the device, a photo image of the back surfaces of the legs was previously entered. Using this program, a grid with points for measuring temperature was superimposed on this photo image (Fig. 47).

The first thermogram is shown in Fig. 48. The program automatically generated the following conclusion: “Maximum thermal asymmetry of 0.6 ° C. The longitudinal gradient is 1 ° C on the left and 0.8 ° C on the right ”(note: green letters).

After a minor injury, severe pain appeared in the upper third of the left lower leg, pain during palpation along the vein. A self-examination using the inventive device showed a thermogram shown in Fig. 49. After comparing it with the previous thermogram, the following conclusion was automatically generated: “The maximum thermal asymmetry is 1.8 ° C. Hyperthermia zone on the left 25%. The longitudinal gradient on the left is 0 ° C, on the right 0.8 ° C. Thermal signs of negative dynamics. Local therapeutic effects are recommended mainly in the hyperthermia zone ”(note: red letters).

The patient forwarded using the inventive device all the results of the self-examination to the doctor to receive a telemedicine consultation. The doctor of the telemedicine center during an online consultation, including using the inventive device, he listened to the patient’s complaints, analyzed the results of self-examination, and also, using the device made from the camera and the photograph sent to him, examined the sore leg. On examination, redness above the varicose vein in the upper third of the left lower leg, slight swelling of the left lower leg is visible. The following diagnosis was made: acute thrombophlebitis of the superficial vein of the left leg. The doctor made the following appointments: bed rest, contraceptive withdrawal, heparin-containing gel (Lioton 1000), nonsteroidal anti-inflammatory drugs (Diclofenac inside), venotonics (Troxerutin inside), applied locally to the hyperthermia zone.

Three days after the start of treatment, the patient conducted a self-examination and received a thermogram shown in Fig.50. After comparing it with the previous thermogram, the following conclusion was automatically generated: “The maximum thermal asymmetry is 1.0 ° C. Hyperthermia zone on the left 20%. The longitudinal gradient on the left is 0.4 ° C, on the right 0.8 ° C. Thermal signs of positive dynamics. Local exposure is recommended primarily on the hyperthermia zone ”(note: yellow letters).

The patient continued treatment, and another week later a thermogram was obtained, shown in Fig. 51. After comparing it with the previous thermogram, the following conclusion was automatically generated: “Maximum thermal asymmetry of 0.6 ° C. The longitudinal gradient on the left is 0.8 ° C, on the right is 0.8 ° C. Thermal attributes of positive dynamics ”(note: green letters).

Example 4

Athlete I. (short-distance runner - sprinter), 20 years old, has the claimed device for controlling muscle warming. Usually conducts self-examination or examination with the help of a trainer in the projection of the muscles of the back of the thigh.

He carries out temperature control of the posterior group of thigh muscles for the reason that he had 3 years ago had a minor injury in this area. This muscle group has an enormous load, as it acts as a muscle brake and must, at a certain point, stop the movement of the leg forward. After the usual warm-up, the temperature of the muscles of the anterior surface of the thigh significantly exceeds the initial temperature, while the temperature of the muscles of the posterior surface of the thigh remains unchanged. The fact is that the quadriceps muscle of the thigh and calf muscle are flexed mainly, and not the muscles of the posterior surface of the thigh. Therefore, they are included immediately in the maximum work almost unprepared, which leads to injury. To warm them up, you need to do special exercises and self-massage.

An image of the rear surfaces of the thighs with fixed points on them — patterns for measuring temperature, which is shown in FIG. 52 — was previously entered into the base of the device.

Before the start of the warm-up, the athlete measured the temperature according to the pattern. The program automatically generated the following conclusion: “Maximum thermal asymmetry of 0.4 ° C. The average temperature on the left is 30.4 ° C, on the right 30.8 ° C ”(note: green letters). After warming up for 10 minutes, the athlete again measured the temperature according to the pattern and compared the results with the previous ones. The program automatically generated the following conclusion: “Maximum thermal asymmetry of 0.4 ° C. The average temperature on the left is 31.2 ° C, on the right 31.6 ° C. Insufficient muscle warming up ”(note: the letters are green and the last phrase is yellow). The athlete warmed up for another 5 minutes, doing special exercises to warm up the back of the thigh muscles and self-massage. He again measured the temperature according to the pattern and compared the results with those that were before the warm-up. The program automatically generated the following conclusion: “Maximum thermal asymmetry of 0.4 ° C. The average temperature on the left is 32.4 ° C, on the right 32.6 ° C. Sufficient muscle warming up ”(note: green letters).

Example 5

Woman B., 30 years old, with initial manifestations of cellulite, began to apply a course of medical procedures, while for objective monitoring of their effectiveness, she used the inventive device according to the instructions for monitoring the effectiveness of cellulite treatment. Before the first procedure, the problem area was photographed by the woman’s spouse, then she manually placed points on the image with a stylus and saved the resulting temperature measurement template, which is shown in FIG. 53, in the device’s memory.

Then she measured the temperature at each point using a remote module and received a thermogram presented in Fig. 54. The program also automatically generated the following conclusion: “The maximum temperature is 28.8 ° C, the minimum temperature is 26.2 ° C, and the average temperature is 27.5 ° C. Hypothermia zone 36.6% ”(note: letters are red).

Before starting the second procedure, she again measured the temperature using the saved pattern of the points on her problem area. The thermogram shown in FIG. 55 was obtained.

The program automatically generated the following conclusion: “The maximum temperature is 29 ° C, the minimum temperature is 26.8 ° C, and the average temperature is 28 ° C. Hypothermia zone 31.7% ”(note: yellow letters). Thus, the minimum and average temperatures in the problem zone increased, and the hypothermia zone also decreased. According to the instructions for monitoring the effectiveness of cellulite treatment, this is a sign of the right therapy. The client decided to do the whole course of procedures. Before the start of the last procedure, she again measured the temperature using the saved pattern. A thermogram was obtained, shown in Fig. 56.

The program automatically generated the following conclusion: “The maximum temperature is 32.2 ° C, the minimum temperature is 31.2 ° C, and the average temperature is 31.7 ° C. Normothermy zone 100% ”(note: green letters). Thus, it objectified the improvement of blood circulation in the problem area, which is one of the main criteria for the success of cellulite treatment.

Claims (1)

A method for monitoring diseases, which includes the single entry and saving in the computer memory of a photo image or a 2D or 3D model of the examined area of the human body with points previously indicated on it for measuring temperature, displaying the indicated image with designated points for measuring temperature, measuring the temperature on the human body at points corresponding to the location of the points indicated on the image, and displaying the tempo on the image of the examined area of measurement results temperature, characterized in that the measured temperature values at the same points on the human body during the monitoring period are stored in the computer memory with their subsequent comparison and the formation of monitoring results based on such a comparison.

Images