Cervical spine signs and symptoms: perpetuating rather than predisposing factors for temporomandibular disorders in women

AIM: The purpose of this study was to assess in a sample of female community cases the relationship between the increase of percentage of cervical signs and symptoms and the severity of temporomandibular disorders (TMD) and vice-versa. MATERIAL AND METHODS: One hundred women (aged 18-26 years) clinically diagnosed with TMD signs and symptoms and cervical spine disorders were randomly selected from a sample of college students. RESULTS: 43% of the volunteers demonstrated the same severity for TMD and cervical spine disorders (CSD). The increase in TMD signs and symptoms was accompanied by increase in CSD severity, except for pain during palpation of posterior temporal muscle, more frequently observed in the severe CSD group. However, increase in pain during cervical extension, sounds during cervical lateral flexion, and tenderness to palpation of upper fibers of trapezius and suboccipital muscles were observed in association with the progression of TMD severity. CONCLUSION: The increase in cervical symptomatology seems to accompany TMD severity; nonetheless, the inverse was not verified. Such results suggest that cervical spine signs and symptoms could be better recognized as perpetuating rather than predisposing factors for TMD

A Randomized Controlled Trial Comparing the Effects of Counseling and Alarm Device on HAART Adherence and Virologic Outcomes

Michael Chung and colleagues show that intensive early adherence counseling at HAART initiation resulted in sustained, significant impact on adherence and virologic treatment failure, whereas use of an alarm device had no effect

Immediate and short-term pain relief by acute sciatic nerve press: a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Despite much research, an immediately available, instantly effective and harmless pain relief technique has not been discovered. This study describes a new manipulation: a "2-minute sciatic nerve press", for rapid short-term relief of pain brought on by various dental and renal diseases.</p> <p>Methods</p> <p>This randomized, single-blind, placebo-controlled trial ran in three hospitals in Anhui Province, China, with an enrollment of 66 out of 111 solicited patients aged 16 to 74 years. Patients were recruited sequentially, by specific participating physicians at their clinic visits to three independent hospitals. The diseases in enrolled dental patients included dental caries, periodontal diseases and dental trauma. Renal diseases in recruits included kidney infections, stones and some other conditions. Patients were randomly assigned to receive the "2-minute sciatic nerve press" or the "placebo press". For the "2-minute sciatic nerve press", pressure was applied simultaneously to the sciatic nerves at the back of the thighs, using the fists while patients lay prone. For the "placebo press", pressure was applied simultaneously to a parallel spot on the front of the thighs, using the fists while patients lay supine. Each fist applied a pressure of 11 to 20 kg for 2 minutes, after which, patients arose to rate pain.</p> <p>Results</p> <p>The "2-minute sciatic nerve press" produced greater pain relief than the "placebo press". Within the first 10 minutes after sciatic pressure, immediate pain relief ratings averaged 66.4% (p < 0.001) for the dental patients, versus pain relief of 20% for the placebo press, and, 52.2% (p < 0.01) for the renal patients, versus relief of 14% for the placebo press, in median. The method worked excellently for dental caries and periodontal diseases, but poorly for dental trauma. Forty percent of renal patients with renal colic did not report any pain relief after the treatment.</p> <p>Conclusion</p> <p>Two minutes of pressure on both sciatic nerves can produce immediate significant conduction analgesia, providing a convenient, safe and powerful way to overcome clinical pain brought on by dental diseases and renal diseases for short term purposes.</p> <p>Trial registration</p> <p>ACTR 12606000439549</p

Estimulação elétrica nervosa transcutânea nas modalidades convencional e acupuntura na dor induzida pelo frio

A estimulação elétrica nervosa transcutânea (TENS) é um recurso não-farmacológico já consagrado na modulação de dores agudas e crônicas. O objetivo deste estudo foi verificar o efeito da TENS convencional e na modalidade TENS-acupuntura na dor induzida pelo frio. Trinta indivíduos saudáveis com idade entre 18 e 40 anos foram distribuídos ao acaso em três grupos: placebo, TENS convencional e TENS-acupuntura. Foi utilizado um protocolo de indução de dor pelo frio composto por seis ciclos: dois pré-tratamento, dois durante e dois após o tratamento. A TENS foi aplicada por 20 minutos por dois canais, sendo a modalidade convencional, no nível sensorial, na freqüência de 80 Hz e a modalidade acupuntura, no nível motor, a 4 Hz. Foram medidos limiar de dor, tolerância à dor e intensidade da dor. Não foi encontrada diferença estatisticamente significante nos valores medidos durante a após o tratamento quando comparados aos dos ciclos pré-tratamento, em todas as variáveis. Nas duas modalidades estudadas pois, a TENS, nos parâmetros de aplicação utilizados, não modificou a dor induzida por frio, sugerindo-se novos estudos com maior tempo de aplicação da TENS e diferentes modelos de dor experimental.Transcutaneous electrical nerve stimulation (TENS) is a non-pharmacological method already established in the modulation of acute and chronic pain. The purpose of this study was to assess the effect of conventional TENS and acupuncture-like TENS on cold-induced pain. Thirty healthy subjects aged 18 to 40 years old were randomized into in three groups: placebo, conventional TENS, and acupuncture-like TENS. A cold-induced pain protocol was used, in six cycles (two pre-treatment, two during, and two after treatment); TENS was applied for 20 minutes through 2 channels, the conventional modality at sensory level at 80 Hz, and the acupuncture modality at motor level at 4 Hz. Variables analysed were pain threshold, tolerance to pain, and pain intensity. No statistically significant differences were found in any variable between post and pre-treatment measures in all groups. Hence neither conventional or acupuncture-like TENS had any effect on cold-induced pain. Further studies are suggested, with different experimental pain models, and with longer time of TENS application

STIMULATION CHARACTERISTICS, COMPLICATIONS, AND EFFICACY OF SPINAL-CORD STIMULATION SYSTEMS IN PATIENTS WITH REFRACTORY ANGINA - A PROSPECTIVE FEASIBILITY STUDY

Objectives: In a prospective study with a 1-year follow-up we evaluated: (1) the feasibility of a method for the adjustment of spinal cord stimulator (SCS) parameters, (2) complications of SCS, and (3) efficacy of SCS. Methods: In patients receiving an SCS for severe angina unresponsive to standard therapies, SCS characteristics were evaluated within 1 week and at 4, 14, 26, and 52 weeks after SCS treatment. Step-by-step adjustment of pulse output parameters was performed at the electrode configuration at which paresthesias occurred (''sensory threshold''), covered the anginal area (''adjusted setting''), or provoked pain (''motor threshold''). In addition, the number of anginal attacks and intake of glyceryl trinitrate (GTN) tablets were recorded at regular intervals. Results: Twenty-two patients with either a bipolar (14) or a unipolar (8) system were evaluated. In the 14 patients with bipolar systems, alteration in paresthesias required 26 reprogrammings of the configuration. in the eight patients with bipolar systems who completed the followup without lead dislocation, the mean ''sensory threshold'' was 3.3 V (1.7-5.6), the mean ''adjusted stimulation'' output was 4.5 V (2.8-7.6), and the mean ''motor threshold'' was 4.9 V (2.8-7.7) after 4 weeks SCS. The mean stimulation duration per 24 hours was 14.2% (5%-24%), and the mean standardized impedance was 821 Omega (748-893) after 4 weeks SCS. The unipolar group demonstrated comparable results. After 1-year follow-up the parameters had not changed significantly. During the I-year followup, 6 of 22 patients experienced lead dislocation that required surgery. In all patients, anginal attacks (P <0.003) and GTN intake (P <0.005) were reduced significantly with SCS. The effect lasted during the 1 year. Conclusions: During a 1-year follow-up, the stimulation parameters did not change significantly in the 16 patients without lead dislocations. Our standardized method appears to be feasible for followup of SCS. Moreover, SCS seems to be an effective adjuvant therapy for intractable angina, despite a relatively frequent dislocation of the electrode