Pain management procedures used by dental and maxillofacial surgeons: an investigation with special regard to odontalgia

BACKGROUND: Little is known about the procedures used by German dental and maxillofacial surgeons treating patients suffering from chronic orofacial pain (COP). This study aimed to evaluate the ambulatory management of COP. METHODS: Using a standardized questionnaire we collected data of dental and maxillofacial surgeons treating patients with COP. Therapists described variables as patients' demographics, chronic pain disorders and their aetiologies, own diagnostic and treatment principles during a period of 3 months. RESULTS: Although only 13.5% of the 520 addressed therapists returned completely evaluable questionnaires, 985 patients with COP could be identified. An orofacial pain syndrome named atypical odontalgia (17.0 %) was frequent. Although those patients revealed signs of chronification, pain therapists were rarely involved (12.5%). For assessing pain the use of Analogue Scales (7%) or interventional diagnostics (4.6%) was uncommon. Despite the fact that surgical procedures are cofactors of COP therapists preferred further surgery (41.9%) and neglected the prescription of analgesics (15.7%). However, most therapists self-evaluated the efficacy of their pain management as good (69.7 %). CONCLUSION: Often ambulatory dental and maxillofacial surgeons do not follow guidelines for COP management despite a high prevalence of severe orofacial pain syndromes

Photonic microwave signals with zeptosecond-level absolute timing noise

Photonic synthesis of radiofrequency revived the quest for unrivalled microwave purity by its seducing ability to convey the benefits of the optics to the microwave world. In this work, we perform a high-fidelity transfer of frequency stability between an optical reference and a microwave signal via a low-noise fiber-based frequency comb and cutting-edge photo-detection techniques. We demonstrate the generation of the purest microwave signal with a fractional frequency stability below 6.5 x 10^-16 at 1 s and a timing noise floor below 41 zs.Hz^-1/2 (phase noise below -173 dBc.Hz^-1 for a 12 GHz carrier). This outclasses existing sources and promises a new era for state-of-the-art microwave generation. The characterization is achieved by building two auxiliary low noise optoelectronic microwave reference and using a heterodyne cross-correlation scheme with lowermost detection noise. This unprecedented level of purity can impact domains such as radar systems, telecommunications and time-frequency metrology. Furthermore, the measurement methods developed here can benefit the characterization of a broad range of signals, beyond comb-based systems.Comment: 21 pages, 3 figure

Spectral purity transfer between optical wavelengths at the 10−1810^{-18} level

Ultra-stable lasers and optical frequency combs have been the enabling technologies for the tremendous progress of precise optical spectroscopy in the last ten years. To improve laser frequency stabilization beyond the thermal-noise fundamental limit of traditional room-temperature high-finesse optical cavities, new solutions have been recently developed. These being complex and often wavelength specific, the capability to transfer their spectral purity to any optical wavelengths is highly desirable. Here we present an optical frequency comb based scheme transferring a $4.5 \times 10^{-16}$ fractional frequency stability from a 1062 nm wavelength laser to a 1542 nm laser. We demonstrate that this scheme does not hinder the transfer down to $3 \times 10^{-18}$ at one second, two orders of magnitude below previously reported work with comparable systems. This exceeds by more than one order of magnitude the stability of any optical oscillator demonstrated to date, and satisfies the stability requirement for quantum-projection-noise limited optical lattice clocks

Força muscular respiratória e capacidade funcional na insuficiência renal terminal

OBJETIVO: Verificar a associação da força muscular respiratória com a capacidade funcional, força proximal de membros inferiores e variáveis bioquímicas em pacientes em hemodiálise (HD). MÉTODOS: Participaram deste estudo 30 indivíduos (18 homens), com 53,4 ± 12,9 anos e tempo de HD de 41,1 ± 55,7 meses. Foram avaliados pressão inspiratória máxima (PImax), pressão expiratória máxima (PEmax), distância percorrida no teste de caminhada de seis minutos (6MWT), número de repetições no teste de sentar-e-levantar em 30 segundos (TSL) e registrados os exames bioquímicos de rotina no serviço. RESULTADOS: Houve diminuição da PEmax em relação aos valores preditos (p = 0,015) e redução na distância percorrida no 6MWT quando comparados com equações de predição (p < 0,001). O logPImax e o logPEmax correlacionaram-se com o número de repetições no TSL (r = 0,476, p = 0,008; r = 0,540, p = 0,002, respectivamente), e com os níveis séricos de fósforo (r = 0,422, p = 0,020; r = 0,639, p < 0,001, respectivamente). A distância no 6MWT correlacionou-se com o logPEmax (r = 0,511; p = 0,004) e com o número de repetições no TSL (r = 0,561; p = 0,001). CONCLUSÃO: A redução da PEmax em pacientes com IRT em HD está associada à capacidade funcional, força proximal de membros inferiores e níveis de fósforo sérico, podendo representar, pelo menos em parte, o baixo desempenho físico-funcional desses pacientes.OBJECTIVE: to evaluate the association of respiratory muscle strength with functional capacity, lower limb strength and biochemical variables in hemodialysis (HD) patients. METHODS: a cross-sectional study involving 30 patients (18 male), 53.4 ± 12.9 years, 41.1 ± 55.7 months on HD therapy. Maximal inspiratory pressure (PImax),maximal expiratory pressure (PEmax),distance completed in a six-minute walk test (6MWT) and number of repetitions in sit-and-stand test (STST) were evaluated. The biochemical variables were recorded in the database routine work service. RESULTS: LogEPmax and 6MWT values were significantly lower than the predicted values (p = 0.015; p < 0.001, respectively). logPImax and logPEmax were correlated with number of repetitions in STST (r = 0.476, p = 0.008; r = 0.540, p = 0.002, respectively) and with phosphorus blood levels (r = 0.422, p = 0.020; r = 0.639, p < 0.001, respectively). 6MWT was correlated with logPEmax (r = 0.511; p = 0.004) and with number of repetitions in STST (r = 0.561; p = 0.001). CONCLUSION: PEmax reduction in patients with ESRD on HD is associated with functional capacity, lower limb strength and phosphorus blood levels, and may at least partly represent the low physical and functional performance of these patients