The impact of stress and anxiety on the pressure pain threshold of myofascial pain patients

The purpose of this study was to evaluate the influence of stress and anxiety on the pressure pain threshold (PPT) of masticatory muscles and on the subjective pain report. Forty-five women, students, with mean age of 19.75 years, were divided into two groups: group 1:29 presenting with masticatory myofascial pain (MFP), according to the Research Diagnostic Criteria for Temporomandibular Disorders and group 2: 16 asymptomatic controls. An electronic algometer registered the pain thresholds on four different occasions throughout the academic year. To measure levels of stress, anxiety and pain, the Beck Anxiety Inventory, Lipp Stress Symptoms Inventory and Visual Analog Scale (VAS) were used. Three-way anova and Tukey`s tests were used to verify differences in PPT between groups, times and sites. Levels of anxiety and VAS were compared using Mann-Whitney test, while Friedman`s test was used for the within-groups comparison at different times (T1 to T4). The chi-squared and Cochran tests were performed to compare groups for the proportion of subjects with stress (alpha = 0.05). Differences in PPT recordings between time (P = 0.001) and sites (P < 0.001) were detected. Higher levels of anxiety and lower PPT figures were detected at T2 (academic examination) (P = 0.001). There was no difference between groups for anxiety and stress at any time (P > 0.05). The MFP group also has shown significant increase of VAS at the time of academic examination (P < 0.001). External stressors such as academic examinations have a potential impact on masticatory muscle tenderness, regardless of the presence of a previous condition such as masticatory myofascial pain.

Palpation of the lateral pterygoid area in the myofascial pain diagnosis

Objectives. To evaluate the diagnostic value of intraoral palpation at the lateral pterygoid (LP) area as part of the physical examination to detect myofascial pain, according to modified research diagnostic criteria for temporomandibular disorders. Study design. Fouty-four women composed the myofascial pain group, and 33 symptom-free age-matched were the control group. One examiner calibrated and blinded to group distribution performed 2 intraoral bilateral palpations of the lateral pterygoid. Results. The LP area palpation showed sensitivity and specificity values of 79.55% and 77.27%, respectively, and positive and negative likelihood ratios of 3.50 and 0.26, respectively. Conclusions. Palpation at the LP area did not reach acceptable values of specificity, and care must be taken when judging positive response to this procedure.

New perspectives on the synoptic and mesoscale structure of Hurricane Catarina

This work explores in detail synoptic and mesoscale features of Hurricane Catarina during its life cycle from a decaying baroclinic wave to a tropical depression that underwent tropical transition (TT) and finally to a Category 2 hurricane at landfall over Santa Catarina State coast, southern Brazil. This unique system caused 11 deaths mostly off the Brazilian coast and an estimated half billion dollars in damage in a matter of a few hours on 28 March 2004. Although the closest meteorological station available was tens of kilometres away from the eye, in situ meteorological measurements provided by a work-team sent to the area where the eye made landfall unequivocally reproduces the tropical signature with category 2 strength, adding to previous analysis where this data was not available. Further analyses are based mostly on remote sensing data available at the time of the event. A classic dipole blocking set synoptic conditions for Hurricane Catarina to develop, dynamically contributing to the low wind shear observed. On the other hand, on its westward transit, large scale subsidence limited its strength and vertical development. Catarina had relatively cool SST conditions, but this was mitigated by favourable air-sea fluxes leading to latent heat release-driven processes during the mature phase. The ocean`s dynamic topography also suggested the presence of nearby warm core rings which may have facilitated the transition and post-transition intensification. Since there were no records of such a system at least in the past 30 years and given that SSTs were generally below 26 degrees C and vertical shear was usually strong, despite all satellite data available, the system was initially classified as an extratropical cyclone. Here we hypothesise that this categorization was based oil inadequate regional scale model outputs which did not account for the importance of the latent heat fluxes over the ocean. Hurricane Catarina represents a dramatic event on weather systems in South America. It has attracted attention worldwide and poses questions as whether or not it is a symptom of global warming. (C) 2009 Elsevier B.V. All rights reserved.