A systematic review and meta-analysis of the prevalence of small fiber pathology in fibromyalgia: Implications for a new paradigm in fibromyalgia etiopathogenesis

Seminars in Arthritis and Rheumatism, Journal Year: 2018, Volume and Issue: 48(5), P. 933 - 940

Published: Aug. 23, 2018

Fibromyalgia is a condition which exhibits chronic widespread pain with neuropathic features and has major impact on health-related quality of life. The pathophysiology remains unclear, however, there increasing evidence for involvement the peripheral nervous system high prevalence small fiber pathology (SFP). aim this systematic literature review to establish SFP in fibromyalgia. An electronic search was performed using MEDLINE, EMBASE, PubMed, Web Science, CINAHL Cochrane Library databases. Published full-text, English language articles that provide data studies fibromyalgia patients over 18years old were included. All screened by two independent reviewers priori criteria. Methodological risk bias evaluated critical appraisal tool Munn et al. Overall subgroup pooled calculated random-effects meta-analysis 95% CI. Database searches found 935 studies; 45 8 full text satisfied inclusion criteria, providing from 222 participants. demonstrated 49% (95% CI: 38–60%) moderate degree heterogeneity, (I2= 68%). estimate attained skin biopsy 45% 32–59%, I2= 70%) corneal confocal microscopy it 59% 40–78%, 51%). There This study provides compelling distinct phenotype involving Identifying will aid determining its relationship potentially facilitate development future interventions pharmacotherapy.

Language: Английский

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Present and future of gait assessment in clinical practice: Towards the application of novel trends and technologies

Frontiers in Medical Technology, Journal Year: 2022, Volume and Issue: 4

Published: Dec. 16, 2022

Background Despite being available for more than three decades, quantitative gait analysis remains largely associated with research institutions and not well leveraged in clinical settings. This is mostly due to the high cost/cumbersome equipment complex protocols data management/analysis traditional labs, as diverse training/experience preference of teams. Observational qualitative scales continue be predominantly used clinics despite evidence less efficacy quantifying gait. Research objective study provides a scoping review status assessment, including shedding light on common pathologies, parameters, indices, scales. We also highlight novel state-of-the-art characterization approaches integration commercially wearable tools technology AI-driven computational platforms. Methods A comprehensive literature search was conducted within PubMed, Web Science, Medline, ScienceDirect all articles published until December 2021 using set keywords, normal pathological gait, analysis, systems, inertial measurement units, accelerometer, gyroscope, magnetometer, insole sensors, electromyography sensors. Original that met selection criteria were included. Results significance Clinical highly observational hence subjective influenced by observer's background experience. Quantitative Instrumented (IGA) has capability providing clinicians accurate reliable diagnosis monitoring but limited applicability mainly logistics. Rapidly emerging smart technology, multi-modality, sensor fusion approaches, platforms are increasingly commanding greater attention assessment. These promise paradigm shift quantification clinic beyond. On other hand, standardization ensuring their feasibility map features human represent them meaningfully remain critical challenges.

Language: Английский

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An artificial intelligence-based deep learning algorithm for the diagnosis of diabetic neuropathy using corneal confocal microscopy: a development and validation study

Diabetologia, Journal Year: 2019, Volume and Issue: 63(2), P. 419 - 430

Published: Nov. 12, 2019

Abstract Aims/hypothesis Corneal confocal microscopy is a rapid non-invasive ophthalmic imaging technique that identifies peripheral and central neurodegenerative disease. Quantification of corneal sub-basal nerve plexus morphology, however, requires either time-consuming manual annotation or less-sensitive automated image analysis approach. We aimed to develop validate an artificial intelligence-based, deep learning algorithm for the quantification fibre properties relevant diagnosis diabetic neuropathy compare it with validated program, ACCMetrics. Methods Our algorithm, which employs convolutional neural network data augmentation, was developed neuropathy. The trained using high-end graphics processor unit on 1698 images; external validation, further tested 2137 images. identify total length, branch points, tail number length segments, fractal numbers. Sensitivity analyses were undertaken determine AUC ACCMetrics our Results intraclass correlation coefficients superior those (0.933 vs 0.825), mean per segment (0.656 0.325), points (0.891 0.570), (0.623 0.257), segments (0.878 0.504) fractals (0.927 0.758). In addition, proposed achieved 0.83, specificity 0.87 sensitivity 0.68 classification participants without ( n = 90) 132) (defined by Toronto criteria). Conclusions/interpretation These results demonstrated provides excellent localisation performance biomarkers. This model has potential adoption into clinical screening programmes Data availability publicly shared cornea dataset (dataset 1) available at http://bioimlab.dei.unipd.it/Corneal%20Nerve%20Tortuosity%20Data%20Set.htm http://bioimlab.dei.unipd.it/Corneal%20Nerve%20Data%20Set.htm .

Language: Английский

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A Systematic Approach to the Design and Characterization of a Smart Insole for Detecting Vertical Ground Reaction Force (vGRF) in Gait Analysis

Sensors, Journal Year: 2020, Volume and Issue: 20(4), P. 957 - 957

Published: Feb. 11, 2020

Gait analysis is a systematic study of human locomotion, which can be utilized in variousapplications, such as rehabilitation, clinical diagnostics and sports activities. The various limitationssuch cost, non-portability, long setup time, post-processing time etc., the current gait analysistechniques have made them unfeasible for individual use. This led to an increase research interestin developing smart insoles where wearable sensors employed detect vertical groundreaction forces (vGRF) other variables. Smart are flexible, portable comfortablefor analysis, monitor plantar pressure frequently through embedded thatconvert applied electrical signal that displayed analyzed further.Several teams still working improve insoles' features size, sensitivity ofinsoles sensors, durability, intelligence control subjects' bydetecting complications providing recommendation enhance walking performance. Eventhough sensor calibration approaches been followed by different calibrateinsoles' sensor, expensive devices were used universal testingmachines or infrared motion capture cameras equipped labs. paper providesa design characterization procedure three sensors: forcesensitiveresistors (FSRs), ceramic piezoelectric flexible canbe detecting vGRF using insole. A simple method based on load cellis presented alternative techniques. In addition, evaluate theperformance component insole, acquired fromdifferent compare them. results showed FSR most effectivesensor among insole applications, whereas start end cycle. will useful any researchgroup replicating customized analysis.

Language: Английский

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Prevalence of peripheral neuropathy in pre-diabetes: a systematic review

BMJ Open Diabetes Research & Care, Journal Year: 2021, Volume and Issue: 9(1), P. e002040 - e002040

Published: May 1, 2021

There is growing evidence of excess peripheral neuropathy in pre-diabetes. We aimed to determine its prevalence, including the impact diagnostic methodology on prevalence rates, through a systematic review conducted according Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive electronic bibliographic search was performed MEDLINE, EMBASE, PubMed, Web Science Cochrane Central Register Controlled Trials from inception June 1, 2020. Two reviewers independently selected studies, extracted data assessed risk bias. An evaluation undertaken by method assessment. After screening 1784 abstracts reviewing 84 full-text records, 29 studies (9351 participants) were included. wide range estimates (2%–77%, IQR: 6%–34%), but majority (n=21, 72%) reported ≥10%. The three highest 77% (95% CI: 54% 100%), 71% 55% 88%) 66% 53% 78%) using plantar thermography, multimodal quantitative sensory testing nerve conduction tests, respectively. In general, evaluating small fiber parameters yielded higher neuropathy. Due variety study populations methods assessing neuropathy, there marked heterogeneity estimates. Most pre-diabetes, primarily origin, than would be expected background population. Given rise further consideration targeting this population required. Development risk-stratification tools may facilitate earlier interventions.

Language: Английский

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Oral Health Messiers: Diabetes Mellitus Relevance

Diabetes Metabolic Syndrome and Obesity, Journal Year: 2021, Volume and Issue: Volume 14, P. 3001 - 3015

Published: July 1, 2021

Abstract: This article aims to narrate the various oral complications in individuals suffering from diabetes mellitus. Google search for "diabetes mellitus and complications" was done. The also carried out mellitus" its individually. Diabetes is a chronic metabolic disorder that global epidemic common cause of morbidity mortality world today. Currently, there are about 422 million cases worldwide. Diabetic patients can develop different body such as retinopathy, neuropathy, nephropathy, cardiovascular disease. Complications cavity have been observed A study noted more than 90% diabetic suffered complications. Another research has shown greater prevalence mucosal disorders with non-diabetic population: 45– 88% type 2 compared 38.3– 45% subjects 44.7% 1 25% population. Oral people periodontal disease, dental caries, infections, salivary dysfunction, taste delayed wound healing, tongue abnormalities, halitosis, lichen planus. high glucose level saliva, poor neutrophil function, small vessel damage contribute uncontrolled diabetes. Good health imperative healthy living. deterioration quality life patients. like disease having bidirectional relationship even increased blood levels intends promote awareness regarding diabetics stress importance maintaining proper hygiene, taking preventive measures, early detection, appropriate management these through multidisciplinary approach. Keywords: mellitus, hyperglycemia, complications, infection, awareness, approach

Language: Английский

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Gold Standard for Diagnosis of DPN

Frontiers in Endocrinology, Journal Year: 2021, Volume and Issue: 12

Published: Oct. 26, 2021

Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus. It often causes symmetrical paresthesia, loss sensation, and hyperalgesia. Without early intervention, it might lead to diabetic foot ulceration, gangrene, subsequent amputation in people with diabetes. DPN an insidious disease underdiagnosed. This paper reviews the current national international prevalence DPN, screening methods for including quantitative sensory measurement, neurological function scoring system, confocal microscopy, high-frequency ultrasound, summarizes related research progress, clinical application, development prospects these recent years.

Language: Английский

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A Wearable Insole System to Measure Plantar Pressure and Shear for People with Diabetes

Sensors, Journal Year: 2023, Volume and Issue: 23(6), P. 3126 - 3126

Published: March 15, 2023

Pressure coupled with shear stresses are the critical external factors for diabetic foot ulceration assessment and prevention. To date, a wearable system capable of measuring in-shoe multi-directional out-of-lab analysis has been elusive. The lack an insole plantar pressure hinders development effective ulcer prevention solution that could be potentially used in daily living environment. This study reports first-of-its-kind sensorised its evaluation laboratory settings on human participants, indicating potential as technology to real-world applications. Laboratory revealed linearity error accuracy were up 3% 5%, respectively. When evaluated healthy participant, change footwear resulted approximately 20%, 75% 82% pressure, medial-lateral anterior-posterior stress, no notable difference peak result wearing insole, was measured. preliminary results showed performance is comparable previously reported research devices. adequate sensitivity assist relevant safe use people diabetes. presents help assess risk environment underpinned by sensing technologies.

Language: Английский

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In-shoe plantar temperature, normal and shear stress relationships during gait and rest periods for people living with and without diabetes

Scientific Reports, Journal Year: 2025, Volume and Issue: 15(1)

Published: March 14, 2025

Abstract Diabetic foot ulcers (DFUs) are a common complication of diabetes. This study aims to investigate the relationships between in-shoe plantar temperature, normal and shear stress during walking rest periods for participants with without For this purpose, novel sensing system was developed embedded in an insole at hallux, first metatarsal head calcaneus region. Ten living diabetes no history previous ulceration ten healthy were recruited. Participants walked on treadmill 15 min then rested 20 wearing insole. Results showed high correlation ( Spearman’s r s ≥ 0.917) heat energy, total temperature change, strain cumulative squared all participants. Importantly, between-group comparisons indications thermal regulation differences diabetes, site showing significantly higher end active period P = 0.0097) although speed mechanical similar. research demonstrates time energy gait. Further is needed quantify as mechanism DFU formation.

Language: Английский

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Instrumental assessment of balance and gait in depression: A systematic review

Psychiatry Research, Journal Year: 2019, Volume and Issue: 284, P. 112687 - 112687

Published: Nov. 10, 2019

Language: Английский

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