Plantar thermography is useful in the early diagnosis of diabetic neuropathy
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/108640 |
Resumo: | OBJECTIVES: This study evaluated plantar thermography sensitivity and specificity in diagnosing diabetic polyneuropathy using cardiac tests (heart rate variability) as a reference standard because autonomic small fibers are affected first by this disease. METHODS: Seventy-nine individuals between the ages of 19 and 79 years old (28 males) were evaluated and divided into three groups: control (n = 37), pre-diabetics (n = 13) and type 2 diabetics (n = 29). The plantar images were recorded at baseline and then minutes after a provocative maneuver (Cold Stress Test) using an infrared camera that is appropriate for clinical use. Two thermographic variables were studied: the thermal recovery index and the interdigital anisothermal technique. Heart rate variability was measured in a seven-test battery that included three spectral indexes (in the frequency domain) and four Ewing tests (the Valsalva maneuver, the orthostatic test, a deep breathing test, and the orthostatic hypotension test). Other classically recommended tests were applied, including electromyography (EMG), Michigan inventory, and a clinical interview that included a neurological physical examination. RESULTS: Among the diabetic patients, the interdigital anisothermal technique alone performed better than the thermal recovery index alone, with a better sensitivity (81.3%) and specificity (46.2%). For the pre-diabetic patients, the three tests performed equally well. None of the control subjects displayed abnormal interdigital anisothermal readouts or thermal recovery indices, which precluded the sensitivity estimation in this sample of subjects. However, the specificity (70.6%) was higher in this group. CONCLUSION: In this study, plantar thermography, which predominately considers the small and autonomic fibers that are commonly associated with a sub-clinical condition, proved useful in diagnosing diabetic neuropathy early. The interdigital anisothermal test, when used alone, performed best. |
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Balbinot, Luciane FachinCanani, Luis Henrique SantosRobinson, Caroline CabralAchaval-Elena, MatildeZaro, Milton Antonio2014-12-25T02:09:54Z20121807-5932http://hdl.handle.net/10183/108640000873621OBJECTIVES: This study evaluated plantar thermography sensitivity and specificity in diagnosing diabetic polyneuropathy using cardiac tests (heart rate variability) as a reference standard because autonomic small fibers are affected first by this disease. METHODS: Seventy-nine individuals between the ages of 19 and 79 years old (28 males) were evaluated and divided into three groups: control (n = 37), pre-diabetics (n = 13) and type 2 diabetics (n = 29). The plantar images were recorded at baseline and then minutes after a provocative maneuver (Cold Stress Test) using an infrared camera that is appropriate for clinical use. Two thermographic variables were studied: the thermal recovery index and the interdigital anisothermal technique. Heart rate variability was measured in a seven-test battery that included three spectral indexes (in the frequency domain) and four Ewing tests (the Valsalva maneuver, the orthostatic test, a deep breathing test, and the orthostatic hypotension test). Other classically recommended tests were applied, including electromyography (EMG), Michigan inventory, and a clinical interview that included a neurological physical examination. RESULTS: Among the diabetic patients, the interdigital anisothermal technique alone performed better than the thermal recovery index alone, with a better sensitivity (81.3%) and specificity (46.2%). For the pre-diabetic patients, the three tests performed equally well. None of the control subjects displayed abnormal interdigital anisothermal readouts or thermal recovery indices, which precluded the sensitivity estimation in this sample of subjects. However, the specificity (70.6%) was higher in this group. CONCLUSION: In this study, plantar thermography, which predominately considers the small and autonomic fibers that are commonly associated with a sub-clinical condition, proved useful in diagnosing diabetic neuropathy early. The interdigital anisothermal test, when used alone, performed best.application/pdfengClinics. São Paulo. Vol. 67, n. 12 (2012), p. 1419-1425TermografiaNeuropatias diabéticasFibras nervosasThermographyDiabetic neuropathyCardiac autonomic neuropathySmall fibers neuropathyPlantar thermography is useful in the early diagnosis of diabetic neuropathyEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSORIGINAL000873621.pdf000873621.pdfTexto completo (inglês)application/pdf674854http://www.lume.ufrgs.br/bitstream/10183/108640/1/000873621.pdf720248f2a8268ff8cd0da7dd378ab9d9MD51TEXT000873621.pdf.txt000873621.pdf.txtExtracted Texttext/plain39038http://www.lume.ufrgs.br/bitstream/10183/108640/2/000873621.pdf.txt68ccefb40c90fd621e41d6a0788419e7MD52THUMBNAIL000873621.pdf.jpg000873621.pdf.jpgGenerated Thumbnailimage/jpeg2022http://www.lume.ufrgs.br/bitstream/10183/108640/3/000873621.pdf.jpgf6ca7b6cbf1b0668ed9f6f76249abecdMD5310183/1086402018-10-22 09:32:06.328oai:www.lume.ufrgs.br:10183/108640Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2018-10-22T12:32:06Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Plantar thermography is useful in the early diagnosis of diabetic neuropathy |
title |
Plantar thermography is useful in the early diagnosis of diabetic neuropathy |
spellingShingle |
Plantar thermography is useful in the early diagnosis of diabetic neuropathy Balbinot, Luciane Fachin Termografia Neuropatias diabéticas Fibras nervosas Thermography Diabetic neuropathy Cardiac autonomic neuropathy Small fibers neuropathy |
title_short |
Plantar thermography is useful in the early diagnosis of diabetic neuropathy |
title_full |
Plantar thermography is useful in the early diagnosis of diabetic neuropathy |
title_fullStr |
Plantar thermography is useful in the early diagnosis of diabetic neuropathy |
title_full_unstemmed |
Plantar thermography is useful in the early diagnosis of diabetic neuropathy |
title_sort |
Plantar thermography is useful in the early diagnosis of diabetic neuropathy |
author |
Balbinot, Luciane Fachin |
author_facet |
Balbinot, Luciane Fachin Canani, Luis Henrique Santos Robinson, Caroline Cabral Achaval-Elena, Matilde Zaro, Milton Antonio |
author_role |
author |
author2 |
Canani, Luis Henrique Santos Robinson, Caroline Cabral Achaval-Elena, Matilde Zaro, Milton Antonio |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Balbinot, Luciane Fachin Canani, Luis Henrique Santos Robinson, Caroline Cabral Achaval-Elena, Matilde Zaro, Milton Antonio |
dc.subject.por.fl_str_mv |
Termografia Neuropatias diabéticas Fibras nervosas |
topic |
Termografia Neuropatias diabéticas Fibras nervosas Thermography Diabetic neuropathy Cardiac autonomic neuropathy Small fibers neuropathy |
dc.subject.eng.fl_str_mv |
Thermography Diabetic neuropathy Cardiac autonomic neuropathy Small fibers neuropathy |
description |
OBJECTIVES: This study evaluated plantar thermography sensitivity and specificity in diagnosing diabetic polyneuropathy using cardiac tests (heart rate variability) as a reference standard because autonomic small fibers are affected first by this disease. METHODS: Seventy-nine individuals between the ages of 19 and 79 years old (28 males) were evaluated and divided into three groups: control (n = 37), pre-diabetics (n = 13) and type 2 diabetics (n = 29). The plantar images were recorded at baseline and then minutes after a provocative maneuver (Cold Stress Test) using an infrared camera that is appropriate for clinical use. Two thermographic variables were studied: the thermal recovery index and the interdigital anisothermal technique. Heart rate variability was measured in a seven-test battery that included three spectral indexes (in the frequency domain) and four Ewing tests (the Valsalva maneuver, the orthostatic test, a deep breathing test, and the orthostatic hypotension test). Other classically recommended tests were applied, including electromyography (EMG), Michigan inventory, and a clinical interview that included a neurological physical examination. RESULTS: Among the diabetic patients, the interdigital anisothermal technique alone performed better than the thermal recovery index alone, with a better sensitivity (81.3%) and specificity (46.2%). For the pre-diabetic patients, the three tests performed equally well. None of the control subjects displayed abnormal interdigital anisothermal readouts or thermal recovery indices, which precluded the sensitivity estimation in this sample of subjects. However, the specificity (70.6%) was higher in this group. CONCLUSION: In this study, plantar thermography, which predominately considers the small and autonomic fibers that are commonly associated with a sub-clinical condition, proved useful in diagnosing diabetic neuropathy early. The interdigital anisothermal test, when used alone, performed best. |
publishDate |
2012 |
dc.date.issued.fl_str_mv |
2012 |
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2014-12-25T02:09:54Z |
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dc.language.iso.fl_str_mv |
eng |
language |
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dc.relation.ispartof.pt_BR.fl_str_mv |
Clinics. São Paulo. Vol. 67, n. 12 (2012), p. 1419-1425 |
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