![]() ![]() ![]() Thrills in the upper right sternal border are usually of aortic origin and are seen in AS. Thrills in the upper left sternal border originate from the pulmonary valve or PA and therefore are present in PS, PA stenosis, or PDA (rarely). However, the fingers are used to feel a thrill in the suprasternal notch and over the carotid arteries. A thrill on the chest is felt better with the palm of the hand than with the tips of the fingers. Palpation for thrills is often of diagnostic value. Thrills are vibratory sensations that represent palpable manifestations of loud, harsh murmurs. ![]() Quality of life was assessed using the NeuroQOL, an 18-item survey that addresses six specific domains (pain, lost/reduced feeling, sensory/motor symptoms, functional, social, and emotional experiences), as well as an assessment of overall quality of life ( Vileikyte et al., 2003). Abnormal VPT was defined as a threshold value more than 2.5 standard deviations above the age-adjusted mean value obtained from nondiabetic referents ( Martin et al., 2010). VPT was measured using a forced-choice algorithm of decreasing vibration intensity at the dominant index finger and great toe ( Martin et al., 2010). Vibration perception threshold (VPT) and a neuropathy-specific quality-of-life instrument (NeuroQOL) were included at EDIC year 13/14 (NeuroEDIC) based on recommendations of post-DCCT era consensus panels that recommended quantitative sensory testing and quality-of-life measures as key components of neuropathy outcome measurement in clinical trials ( Boulton, Malik, Arezzo, & Sosenko, 2004 Boulton et al., 2005). Martin, in International Review of Neurobiology, 2016 2.1.3 Additional DSPN Measures in EDIC ![]()
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