Reliability of peak foot pressure in patients with previous diabetic foot ulceration

Publication date: Available online 4 February 2019

Source: Gait & Posture

Author(s): Pei-Yueng Lee, Pui-Wah Kong, Yong-Hao Pua

Abstract

Background

Previous reliability studies on peak plantar pressure measurements in patients with previous diabetic foot ulceration (DFU) did not stratify their analyses according to whether the foot had a previous ulcer.

Research question

Does test-retest reliability of peak foot pressure measurements from the various foot regions differ between the ulcerated and non-ulcerated feet?

Methods

Data from 23 participants with peripheral neuropathy and healed plantar DFU were analysed in this test-retest reliability comparison study. Plantar pressure was evaluated on two sessions using Pedar^®-X in-shoe system, with a mean of 7.2 days (SD = 1.6) between sessions.

Results

The intraclass correlation coefficient (ICC) and coefficient of variation (CV) were calculated for 10 foot regions. Overall, test-retest reliability was excellent (ICCs, 0.82 to 0.95) for all peak pressure variables. CV ranged between 6.3% and 18.3%, and exceeded 15% over the hallux and medial forefoot regions in the ulcer foot (18.3% and 16.4%, respectively). Hallux peak pressure CV was significantly higher over the ulcer foot than over the non-ulcer foot (5.7%, 95% CI, 1.7% to 10.2%). Peak pressure CV over the forefoot also tended to be higher over the ulcer foot (medial forefoot: 6.1%, 95% CI, -0.5% to 14.5%; lateral forefoot: 4.1%, 95%CI, -0.7% to 11.1%).

Significance

Peak plantar foot pressure may be useful to distinguish between groups of patients with peripheral neuropathy and healed plantar DFU. However, clinical decisions based on ulcer foot hallux and forefoot peak pressure measurements should be interpreted with caution.

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Reliability of peak foot pressure in patients with previous diabetic foot ulceration

Publication date: Available online 4 February 2019

Source: Gait & Posture

Author(s): Pei-Yueng Lee, Pui-Wah Kong, Yong-Hao Pua

Abstract

Background

Previous reliability studies on peak plantar pressure measurements in patients with previous diabetic foot ulceration (DFU) did not stratify their analyses according to whether the foot had a previous ulcer.

Research question

Does test-retest reliability of peak foot pressure measurements from the various foot regions differ between the ulcerated and non-ulcerated feet?

Methods

Data from 23 participants with peripheral neuropathy and healed plantar DFU were analysed in this test-retest reliability comparison study. Plantar pressure was evaluated on two sessions using Pedar^®-X in-shoe system, with a mean of 7.2 days (SD = 1.6) between sessions.

Results

The intraclass correlation coefficient (ICC) and coefficient of variation (CV) were calculated for 10 foot regions. Overall, test-retest reliability was excellent (ICCs, 0.82 to 0.95) for all peak pressure variables. CV ranged between 6.3% and 18.3%, and exceeded 15% over the hallux and medial forefoot regions in the ulcer foot (18.3% and 16.4%, respectively). Hallux peak pressure CV was significantly higher over the ulcer foot than over the non-ulcer foot (5.7%, 95% CI, 1.7% to 10.2%). Peak pressure CV over the forefoot also tended to be higher over the ulcer foot (medial forefoot: 6.1%, 95% CI, -0.5% to 14.5%; lateral forefoot: 4.1%, 95%CI, -0.7% to 11.1%).

Significance

Peak plantar foot pressure may be useful to distinguish between groups of patients with peripheral neuropathy and healed plantar DFU. However, clinical decisions based on ulcer foot hallux and forefoot peak pressure measurements should be interpreted with caution.

from #Audiology via ola Kala on Inoreader http://bit.ly/2Typ95t

Hypertrophic pachymeningitis: idiopathic or secondary?

http://bit.ly/2WKzBcj

Intracranial arterial dolichoectasia and skull damage in a girl with Jaffe-Campanacci syndrome: a case report

Abstract

ᅟJaffe-Campanacci is a rare syndrome characterised by axillary freckles, multiple non-ossifying fibromas of the long bones and jaw, and café-au-lait spots, associated with some features of neurofibromatosis type 1 (NF1). Cherix et al. and Colby and Saul suggested that Jaffe-Campanacci syndrome (JCS) might be a distinct form of NF1. Intracranial arterial dolichoectasia (IADE) is defined as an increase in the length and diameter of at least one intracranial artery. Affected intracranial arteries are dilated, elongated and sometimes tortuous. But in this rare disease of JCS, neither skull damage nor IADE has been previously reported. Here, we introduce the case of an 11-year-old Chinese girl with IADE, skull damage and features of JCS.

http://bit.ly/2RCzLOR

On the functional compartmentalization of the normal middle ear. Morpho-histological modelling parameters of its mucosa.

Publication date: Available online 5 February 2019

Source: Hearing Research

Author(s): Simona Padurariu, Christof Röösli, Rasmus Røge, Allan Stensballe, Mogens Vyberg, Alex Huber, Michael Gaihede

Abstract

Background

Middle ear physiology includes both sound pressure transmission and homeostasis of its static air pressure. Pressure gradients are continuously created by gas exchange over the middle ear mucosa as well as by ambient pressure variations. Gas exchange models require actual values for regional mucosa thickness, blood vessel density, and diffusion distance. Such quantitative data have been scarce and limited to few histological samples from the tympanic cavity (TC) and the antrum. However, a detailed regional description of the morphological differences of the TC and mastoid air cell system (MACS) mucosa has not been available. The aim of the present study was to provide such parameters.

Methods

The study included sets of three histological H&E-slides from 15 archived healthy temporal bones. We performed a comparison of the mucosa morphology among the following regions: (1) anterior TC; (2) inferior TC; (3) posterior TC; (4) superior TC; (5) MACS antrum; (6) superior MACS; (7) central MACS; (8) inferior MACS.

Results

Regions (1) - (3), situated below the inter-attico-tympanic diaphragm, had the largest proportion of high respiratory epithelium, cilia and loose lamina propria within the mucosa, as well as the thickest mucosa and the largest diffusion distance. Regions (6) - (8), situated above the diaphragm, had the thinnest mucosa, the shortest distance to the blood vessels, together with the largest proportion of flat epithelium and very few cilia. Regions (4) - (5), still supradiaphragmatic, had intermediary values for these parameters, but generally closer to regions (6) - (8). The blood vessel density and the proportion of active mucosa were not significantly different among the regions.

Conclusion

Mucosa of regions (1), (2) and (3) represented a predominantly clearance-specific morphology, whereas in regions (4) - (8) it seemed adapted to gas exchange. However, the lack of statistically significant differences in blood vessel density and proportion of active mucosa indicated that all regions could be involved in gas exchange with the highest adaptation in the superior MACS. This pattern divides the middle ear functionally along the inter-attico-tympanic diaphragm rather than the anatomical division into TC and MACS.

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On the functional compartmentalization of the normal middle ear. Morpho-histological modelling parameters of its mucosa.

Publication date: Available online 5 February 2019

Source: Hearing Research

Author(s): Simona Padurariu, Christof Röösli, Rasmus Røge, Allan Stensballe, Mogens Vyberg, Alex Huber, Michael Gaihede

Abstract

Background

Middle ear physiology includes both sound pressure transmission and homeostasis of its static air pressure. Pressure gradients are continuously created by gas exchange over the middle ear mucosa as well as by ambient pressure variations. Gas exchange models require actual values for regional mucosa thickness, blood vessel density, and diffusion distance. Such quantitative data have been scarce and limited to few histological samples from the tympanic cavity (TC) and the antrum. However, a detailed regional description of the morphological differences of the TC and mastoid air cell system (MACS) mucosa has not been available. The aim of the present study was to provide such parameters.

Methods

The study included sets of three histological H&E-slides from 15 archived healthy temporal bones. We performed a comparison of the mucosa morphology among the following regions: (1) anterior TC; (2) inferior TC; (3) posterior TC; (4) superior TC; (5) MACS antrum; (6) superior MACS; (7) central MACS; (8) inferior MACS.

Results

Regions (1) - (3), situated below the inter-attico-tympanic diaphragm, had the largest proportion of high respiratory epithelium, cilia and loose lamina propria within the mucosa, as well as the thickest mucosa and the largest diffusion distance. Regions (6) - (8), situated above the diaphragm, had the thinnest mucosa, the shortest distance to the blood vessels, together with the largest proportion of flat epithelium and very few cilia. Regions (4) - (5), still supradiaphragmatic, had intermediary values for these parameters, but generally closer to regions (6) - (8). The blood vessel density and the proportion of active mucosa were not significantly different among the regions.

Conclusion

Mucosa of regions (1), (2) and (3) represented a predominantly clearance-specific morphology, whereas in regions (4) - (8) it seemed adapted to gas exchange. However, the lack of statistically significant differences in blood vessel density and proportion of active mucosa indicated that all regions could be involved in gas exchange with the highest adaptation in the superior MACS. This pattern divides the middle ear functionally along the inter-attico-tympanic diaphragm rather than the anatomical division into TC and MACS.

from #Audiology via ola Kala on Inoreader http://bit.ly/2Bkud6l

On the functional compartmentalization of the normal middle ear. Morpho-histological modelling parameters of its mucosa.

Publication date: Available online 5 February 2019

Source: Hearing Research

Author(s): Simona Padurariu, Christof Röösli, Rasmus Røge, Allan Stensballe, Mogens Vyberg, Alex Huber, Michael Gaihede

Abstract

Background

Middle ear physiology includes both sound pressure transmission and homeostasis of its static air pressure. Pressure gradients are continuously created by gas exchange over the middle ear mucosa as well as by ambient pressure variations. Gas exchange models require actual values for regional mucosa thickness, blood vessel density, and diffusion distance. Such quantitative data have been scarce and limited to few histological samples from the tympanic cavity (TC) and the antrum. However, a detailed regional description of the morphological differences of the TC and mastoid air cell system (MACS) mucosa has not been available. The aim of the present study was to provide such parameters.

Methods

The study included sets of three histological H&E-slides from 15 archived healthy temporal bones. We performed a comparison of the mucosa morphology among the following regions: (1) anterior TC; (2) inferior TC; (3) posterior TC; (4) superior TC; (5) MACS antrum; (6) superior MACS; (7) central MACS; (8) inferior MACS.

Results

Regions (1) - (3), situated below the inter-attico-tympanic diaphragm, had the largest proportion of high respiratory epithelium, cilia and loose lamina propria within the mucosa, as well as the thickest mucosa and the largest diffusion distance. Regions (6) - (8), situated above the diaphragm, had the thinnest mucosa, the shortest distance to the blood vessels, together with the largest proportion of flat epithelium and very few cilia. Regions (4) - (5), still supradiaphragmatic, had intermediary values for these parameters, but generally closer to regions (6) - (8). The blood vessel density and the proportion of active mucosa were not significantly different among the regions.

Conclusion

Mucosa of regions (1), (2) and (3) represented a predominantly clearance-specific morphology, whereas in regions (4) - (8) it seemed adapted to gas exchange. However, the lack of statistically significant differences in blood vessel density and proportion of active mucosa indicated that all regions could be involved in gas exchange with the highest adaptation in the superior MACS. This pattern divides the middle ear functionally along the inter-attico-tympanic diaphragm rather than the anatomical division into TC and MACS.

from #Audiology via ola Kala on Inoreader http://bit.ly/2Bkud6l
via IFTTT