| Testing for loss of protective sensation in patients with foot ulceration: a cross-sectional study. | |
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MedLine Citation:
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PMID: 16166466 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Current recommendations for the prevention of foot ulceration and amputation include screening at-risk individuals by testing for loss of protective sensation at eight sites using 10-g (5.07) nylon monofilaments. Yet measurement of the cutaneous pressure threshold to differentiate one-point from two-point static touch stimuli may allow identification of these at-risk individuals earlier in the clinical course of diabetic neuropathy. The present study tested this hypothesis using a prospective, cross-sectional, multicenter design that included sensibility testing of 496 patients with diabetic neuropathy, 17 of whom had a history of ulceration or amputation. Considering the cutaneous pressure threshold of the 5.07 Semmes-Weinstein nylon monofilament to be equivalent to the 95 g/mm(2) one-point static touch measured using the Pressure-Specified Sensory Device (Sensory Management Services LLC, Baltimore, Maryland), only 3 of these 17 patients with a history of foot ulceration or amputation would have been identified using the Semmes-Weinstein nylon monofilament screening technique. In contrast, using the Pressure-Specified Sensory Device, all 17 patients were identified as having abnormal sensibility, defined as greater than the 99% confidence limit for age, for two-point static touch on the hallux pulp. We conclude that patients at risk for foot ulceration can best be identified by actual measurement of the cutaneous sensibility of the hallux pulp. |
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Authors:
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William A Wood; Michael A Wood; Scott A Werter; Joseph J Menn; Scott A Hamilton; Richard Jacoby; A Lee Dellon |
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Publication Detail:
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Type: Journal Article; Multicenter Study |
Journal Detail:
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Title: Journal of the American Podiatric Medical Association Volume: 95 ISSN: 8750-7315 ISO Abbreviation: J Am Podiatr Med Assoc Publication Date: 2005 Sep-Oct |
Date Detail:
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Created Date: 2005-09-16 Completed Date: 2006-01-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8501423 Medline TA: J Am Podiatr Med Assoc Country: United States |
Other Details:
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Languages: eng Pagination: 469-74 Citation Subset: IM |
Affiliation:
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Foot Health Center, East Lansing, IL, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cross-Sectional Studies Diabetic Foot / physiopathology*, prevention & control Humans Mass Screening / methods Pressure Prospective Studies Reproducibility of Results Retrospective Studies Sensation* Sensory Thresholds Touch |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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