The performance evaluation of the five inspection methods in the diagnosis of peripheral neuropathy in diabetes / 西安交通大学学报(医学版)

Objective To evaluate the diagnostic value of the 10 g nylon silk,vibration threshold value,sense of temperature,pain sense and ankle reflex in the diagnosis of diabetic peripheral neuropathy (DPN)and to search an exact diagnostic method of DPN not only economical but also easy to handle.Methods To carry out the measurements of the NCV,10 g nylon silk,vibration threshold value,sense of temperature,pain sense and ankle reflex on the patients who have been diagnosed with diabetes (DM)between April 2014 and June 2014 in the endocrinology department of our hospital.The sensitivity,specificity,positive forecast value,negative forecast value,Youden index and K value serve as assessments of the diagnostic efficiency of clinically diagnostic criteria. Results The sensitivity,specificity,positive forecast value,negative forecast value,Youden index and K value of the ankle reflex are 66.04%,95.56%,97.22%,54.43%,61.60%,and 0.5 1 in mediate accordance with the diagnostic criteria and it is the best one among the five methods.While the sensitivity and accordance of the pressure sense are of the least accordance with the diagnostic criteria.The correspondent value of the combination of vibration threshold sense,temperature sense and ankle reflex are respectively 86.79%,91.11%,95.83%,74.55%, 77.90% and 0.73,in positive accordance with the diagnostic criteria.Conclusion Among the five methods the consistency between the combination of vibration threshold sense,temperature sense and ankle reflect and diagnostic criteria is of positive accordance and can be applied in screening DPN clinically.

The influence of sour taste and cold temperature in pharyngeal transit duration in patients with stroke

CONTEXT: The effect of sour taste and food temperature variations in dysphagic patients has not been entirely clarified. OBJECTIVE: To determine the effect of sour and cold food in the pharyngeal transit times of patients with stroke. METHODS: Patients participating in this study were 30 right-handed adults, 16 of which were male and 14 were female, aged 41 to 88 (average age 62.3 years) with ictus varying from 1 to 30 days (median of 6 days). To analyze the pharyngeal transit time a videofluoroscopy swallow test was performed. Each patient was observed during swallow of a 5 mL paste bolus given by spoon, totaling four different stimuli (natural, cold, sour and cold sour), one at a time, room temperature (22ºC) and cold (8ºC) were used. Later, the tests were analyzed using specific software to measure bolus transit time during the pharyngeal phase. RESULTS: The results showed that the pharyngeal transit time was significantly shorter during swallow of cold sour bolus when compared with other stimuli. Conclusion - Sour taste stimuli associated to cold temperature cause significant change in swallowing patterns, by shortening the pharyngeal transit time, which may lead to positive effects in patients with oropharyngeal dysphagia.

CONTEXTO: O efeito do sabor azedo e as variações da temperatura dos alimentos em indivíduos disfágicos, ainda não foi totalmente esclarecidos. OBJETIVO: Verificar o efeito do sabor azedo e da temperatura fria no tempo de trânsito faríngeo da deglutição em indivíduos após acidente vascular encefálico hemisférico isquêmico. MÉTODOS: Participaram deste estudo 30 indivíduos adultos, sendo 16 do gênero masculino e 14 do feminino, destros, com faixa etária variando de 41 a 88 anos (média de 62,3 anos) e ictus que variou de 1 a 30 dias (mediana de 6 dias). Para analisar o tempo de trânsito faríngeo da deglutição foi realizado o exame de videofluoroscopia da deglutição. Cada indivíduo foi observado durante a deglutição de bolo na consistência pastosa, oferecido em colher, com 5 mL cada, sendo ao todo quatro estímulos diferentes, um por vez. Posteriormente os exames foram analisados com auxílio de um software específico para medição do tempo de deslocamento do bolo pela fase faríngea. RESULTADOS: Os resultados mostraram que o tempo de trânsito faríngeo da deglutição foi significantemente menor durante a deglutição de bolo azedo gelado quando comparado aos outros estímulos. CONCLUSÃO: Constatou-se que estímulos com sabor azedo associado à temperatura fria provocam significativa mudança na dinâmica da deglutição, diminuindo o tempo de trânsito faríngeo, podendo assim proporcionar efeitos positivos em indivíduos com disfagia orofaríngea.

The Effect of Pre-warming for Patients under Abdominal Surgery on Body Temperature, Anxiety, Pain, and Thermal Comfort

PURPOSE: The purpose of this study was to examine the effect of pre-warming on body temperature, anxiety, pain, and thermal comfort. METHODS: Forty patients who were scheduled for abdominal surgery were recruited as study participants and were assigned to the experimental or control group. For the experimental group, a forced air warmer was applied for 45-90 min (M=68.25, SD=15.50) before surgery. Body temperature and anxiety were measured before and after the experiment, but pain and thermal comfort were assessed only after the surgery. Hypotheses were tested using t-test and repeated measured ANOVA. RESULTS: The experimental group showed higher body temperature than the control group from right before induction to two hours after surgery. Post-operative anxiety and pain in the experimental group were less than those of the control group. In addition, the score of thermal comfort was significantly higher in the experiment group. CONCLUSION: Pre-warming is effective in maintaining body temperature, lowering sensitivity to pain and anxiety, and promoting thermal comfort. Therefore, pre-warming can be recommended as a preoperative nursing intervention.

Achados fonoaudiológicos na hanseníase: considerações teóricas / Speech-language findings on Hansen's disease: theoretical considerations

A hanseníase é uma doença que tem altos níveis de incidência no Brasil. De origem bacteriana crônica, com alta infectividade e baixa patogenicidade, tem como hospedeiro primário o homem e como agente etiológico o Mycobacterium leprae. O bacilo de Hansen, como também é conhecido o agente, se acumula principalmente na pele, nos nervos periféricos e pares cranianos, levando a diversas lesões cutâneas, também à perda da condução neural e, consequentemente, a severas alterações anatômicas e funcionais nas extremidades do corpo, como membros e região orofacial. De acordo com estas premissas, foi realizada uma revisão da literatura com intuito de mostrar a fisiopatologia da doença e sua classificação de acordo com as suas manifestações. Desta forma, a literatura, por intermédio de alguns estudos, mostrou que esta doença pode provocar alterações que comprometem significativamente a voz, a audição, os órgãos fonoarticulatórios e as funções estomatognáticas, tornando-se assim, de grande relevância à Fonoaudiologia.

Hansen's disease is a malady that has high incidence levels in Brazil. It has a chronic bacterial origin, with high infectivity and low pathogenicity, having the man as its primary host, and the Mycobacterium leprae as its etiological agent. The Hansen's bacillus, as it is known, accumulates mainly in the skin, the peripheral nerves and the cranial nerves pairs, causing many skin lesions, as well as loss of neural conduction and, consequently, severe anatomical and functional changes in the ends of the body, such as members and the orofacial region. Based on these premisses, it was carried out a literature review in order to show the pathophysiology of the disease and its classification according to its manifestations. The literature review showed, through some studies, that the disease might cause alterations that significantly compromise the voice, the hearing, the phonoarticulatory organs, and the stomatognathic functions, thus becoming relevant to be studied in Speech-Language Pathology.

Significance of quantitative thermal testing in the diagnosis of diabetic peripheral neuropathy / 中华神经科杂志

Objective To investigate the significance of quantitative thermal testing (QTT) in the diagnosis of diabetic peripheral neuropathy. Methods One hundred and sixty-nine diabetic patients with neurological deficit (DM group) and 53 age-matched healthy controls underwent the determination of cold threshold (CT), warm threshold (WT), clod pain threshold (CPT), warm pain threshold (WPT) in both dorsum of hand and dorsum of foot. DM group were divided into subgroups with a course of disease > 5 years or with a course of disease ≤ 5 years, or divided into subgroups with normal or abnormal nerve conduction study (NCS). Results CT and WT of DM group with a course of disease ≤ 5 years ((29.6 ± 1.4), (26. 5±4. 3) ℃ ; (35.9±3.0), (41.3±4. 0) ℃) were higher than the health controls' ((30. 2±1.2), (29.1±1.5) ℃; (35.0±1.9), (36.5±1.5) ℃, respectively; t=3.27, 6.63, 2.80, 8.61, all P< 0. 05). The CT and WT of DM group with a course of disease > 5 years' ((28. 2±4. 0), (23. 1 ±7.9) ℃ ; (37.0±4. 7), (42. 6±4. 2) ℃, respectively) were higher than the DM group with course of disease≤ 5 years(t =4. 09, 4.63, 2.55, 2. 68 ,all P <0. 05). CT and WT of the normal NCS group((29. 5 ± 1.8), (27.0±4. 6) ℃ ; (35.0±1.9), (40. 9±3. 8)℃, respectively) were higher than the healthy controls' , and the difference was significant(t =3.22, 4. 17, 3.51,9. 95,all P<0.01). The frequency of abnormal QTT in DM group was higher than that of NCS in DM group. The QTT and NCS of DM group with a course of disease >5 years were higher than these in DM group with a course of disease ≤5 years; the frequency of abnormal WT in DM group(86. 4% ,146/169)was higher than that of CT in DM group(68. 1% ,115/169,x2=15.49, P<0.01), the frequency of abnormal QTT in the dorsum of foot in DM group was higher than that in the dorsum of hand in the DM group. PT of diabetic patients were higher than that in the healthy controls. Condusions QTT is more sensitive than NCS in the diagnosis diabetic peripheral neuropathy, which is neeossary to assist NCS when diabetic peripheral neuropathy is suspected, WT in dorsum of foot is a sensitive parameter in the diagnosis of diabetic peripheral neuropathy.

Application of quantitative sensory testing in diagnosis of diabetic peripheral neuropathy / 中华内分泌代谢杂志

Objective To evaluate the application of quantitative sensory testing (QST) to diabetic peripheral neuropathy. Methods TSA 2001 thermal sensory analyzer and VSA 6003 vibratory sensory analyzer made in Israel were used for thermal, vibratory tests and sensory conduction velocity (SCV) at four different locations of extremities in 45 diabetics and 22 normal persons. Results The thermal threshold (TT) and vibratory threshold (VT) of the diabetics were higher than those of age matched normal controls. In diabetics the TT was more frequently abnormal than the VT, which suggested that the small nerve fibers were more vulnerable than large fibers. Quantitative thermal testing (QTT) was more sensitive than quantitative vibratory testing (QVT) and SCV in diabetic peripheral neuropathy, especially in subclinical neuropathy. There was no significant correlation between the TT or VT and blood glucose in diabetics. Conclusion QTT is a sensitive method for diagnosis of diabetic neuropathy.