[Neuropad test in evaluation of diabetic foot]. / Testul Neuropad in evaluarea piciorului diabetic.

AIM: Diabetic neuropathy (DN) is the main cause of foot ulceration. One of the earliest modifications is the loss of normal sudomotor function, a sign of autonomic neuropathy. The aim of this study is to evaluate sudomotor dysfunction using a new tool (Neuropad) in diabetic patients with foot ulceration. MATERIAL AND METHODS: We included 58 diabetic patients with foot ulceration admitted in 2010 in the Clinical Center for Diabetes, Nutrition and Metabolic Diseases. We collected data regarding age, gender, type and duration of diabetes, glycated hemoglobin (HbAlc), history of amputations and duration of hospital admission. Peripheral neuropathy was evaluated through the Neuropathy Disability Score (NDS) and autonomic neuropathy was tested through Neuropad. RESULTS: 95% of patients had NDS > or = 6, among which 76% had also positive Neuropad test. Patients with both peripheral and autonomic neuropathy had longer duration of diabetes (p = 0.027) but similar HbA1c as patients with only peripheral neuropathy (p = 0.09). The former also had longer duration of current admission (p = 0.022) and a higher percentage of these patients had history of amputations (p = 0.041). CONCLUSIONS: Neuropad is a reliable, easy to use test for the diagnosis of autonomic neuropathy, which puts patients at greater risk for foot ulceration and amputation.

[Cutaneous thermographic changes in diabetic polyneuropathy]. / Modificari termografice în polineuropatia diabetica.

AIM: to demonstrate the effectiveness of the thermography method in assessing and diagnosing peripheral polyneuropathy and risk of developing ulcerative lesions in diabetic patients planting. MATERIAL AND METHODS: Study was prospective and included 90 patients of both sexes, aged between 18 and 70 years in the Neurology Clinic of the Rehabilitation Hospital Iasi from January 2010-January 2011. The study group consists of 60 patients diagnosed with type 2 diabetes complicated with sensory- motor polyneuropathy. Control group consisted of 30 patients, selected from apparently healthy general population to assess the normal thermographic profile. To register thermic values it was used a thermal infrared camera FLIR A320 type of setting individual emission on the skin areas examined with automatic temperature correction reflected the distance or relative humidity. RESULTS: Gender distribution of patients in the study group was predominantly male (63%), the ratio M/F = 1.7/1. Motor conduction velocity in the study group was significantly reduced both the SPE (41 +/- 2.8 m/s) and SPI (40.5 +/- 3.1 m/s). Skin temperature was significantly higher in the control group compared with controls, both legs and the plantar surface (33.70 +/- 0.80; 28 +/- 0.50 t degrees C). CONCLUSIONS: Thermographic changes in patients with sensory-motor neuropathy is an early sign in the detection and prevention of risk of injury planting.Thermography can be a useful method for diagnosis and dynamic evaluation of patients with peripheral sensory-motor polyneuropathy.

[Research on correlations between intima media thickness and arterial diameter in patients with stroke]. / Cercetari privind corelatiile între indicele intima-medie si diametrul arterial la pacientii cu accident vascular cerebral.

UNLABELLED: Stroke has become in the last years the first cause of mortality and major invalidity throughout the world. Intima media thickness is a very good marker for subclinical atherosclerosis and also for predicting future cardio and cerebrovascular events. The aim of this study is to try to find some correlations between the value of the intima media thickness and of arterial diameter in patients with stroke. MATERIAL AND METHODS: We evaluated 40 patients, selected by well defined criteria. The intima media thickness (IMT) and arterial diameter were measured with a standard method, by cervical ultrasound mode B, at the common carotid artery. Other parameters considered were age and sex. RESULTS: Gender distribution of subjects in the study group was predominantly male (57,5%), with age between 26 to 78 years old, with a median age of 53,45 +/- 14,40 years old. Statistically, the study group was omogenous regarding age and sex. The IMT value in the study group has varied between 0,5 mm and 1,5 mm on the left side and between 0,5 mm and 1,4 mm on the right side. The value of the arterial diameter has varied between 5,60 mm and 11,90 mm on the left side and between 5,60 mm and 11,20 mm on the right side. Applying the t-Student test we could see no statistical significance (p>0,05). Correlating these values to sex and age we could see a direct correlation between the parameters measured, especially on the right side. CONCLUSIONS: In this study the values of IMT and arterial diameter had no statistical significant value on their own, but were strongly correlated with sex and age in patients with stroke.