Myofascial pain syndrome associated with trigger points: A literature review. (I): Epidemiology, clinical treatment and etiopathogeny

Over the last few decades, advances have been made in the understanding of myofascial pain syndrome epidemiology, clinical characteristics and aetiopathogenesis, but many unknowns remain. An integrated hypothesis has provided a greater understanding of the physiopathology of trigger points, which may allow the development of new diagnostic, and above all, therapeutic methods, as well as the establishment of prevention policies and protocols by the health profession. Nevertheless, randomized studies are needed to provide a better understanding and detection of the different factors involved in the origin of trigger points.

Safety of intramuscular influenza vaccine in patients receiving oral anticoagulation therapy: a single blinded multi-centre randomized controlled clinical trial

Influenza vaccines are recommended for administration by the intramuscular route. However, many physicians use the subcutaneous route for patients receiving an oral anticoagulant because this route is thought to induce fewer hemorrhagic side effects. Our aim is to assess the safety of intramuscular administration of influenza vaccine in patients on oral anticoagulation therapy. Methods: Design: Randomised, controlled, single blinded, multi-centre clinical trial. Setting: 4 primary care practices in Barcelona, Spain. Participants: 229 patients on oral anticoagulation therapy eligible for influenza vaccine during the 20032004 season. Interventions: intramuscular administration of influença vaccine in the experimental group (129 patients) compared to subcutaneous administration in the control group (100 patients). Primary outcome: change in the circumference of the arm at the site of injection at 24 hours. Secondary outcomes: appearance of local reactions and pain at 24 hours and at 10 days; change in INR (International Normalized Ratio) at 24 hours and at 10 days. Analysis was by intention to treat using the 95% confidence intervals of the proportions or mean differences. Results: Baseline variables in the two groups were similar. No major side effects or major haemorrhage during the follow-up period were reported. No significant differences were observed in the primary outcome between the two groups. The appearance of local adverse reactions was more frequent in the subcutaneous administration group (37,4% vs. 17,4%, 95% confidence interval of the difference 8,2% to 31,8%). Conclusion: This study shows that the intramuscular administration route of influenza vaccine in patients on anticoagulant therapy does not have more side effects than the subcutaneous administration route

Orofacial pain of cardiac origin: review literature and clinical cases

The most common types of orofacial pain originate at the dental or periodontal level or in the musculoskeletal structures. However, the patient may present pain in this region even though the source is located elsewhere in the body. One possible source of heterotopic pain is of cardiac origin. Objectives: Report two cases of orofacial pain of cardiac origin and review the clinical cases described in the literature. Study Design: Description of clinical cases and review of clinical cases. Results and conclusions: Nine cases of atypical pain of cardiac origin are recorded, which include 5 females and 4 males. In craniofacial structures, pain of cardiac origin is usually bilateral. At the craniofacial level, the most frequent location described is in the throat and jaw. Pain of cardiac origin is considered atypical due to its location, although roughly 10% of the cases of cardiac ischemia manifest primarily in craniofacial structures. Finally, the differential diagnosis of pain of odontogenic origin must be taken into account with pain of non-odontogenic origin (muscle, psychogenic, neuronal, cardiac, sinus and neurovascular pain) in order to avoid diagnostic errors in the dental practice as well as unnecessary treatments.

Myofascial pain associated to trigger points: A literature review. Part 2: Differential diagnosis and treatment

During the last decades the advance in knowledge of myofascial pain has been constant in the medical and dental community. However, although several aspects have been clarified in relation to its epidemiology, clinical characteristics and etiopathogenesis, many uncertainties remain. Many clinical conditions are included in the differential diagnosis of myofascial pain associated to trigger points. A good anamnesis and clinical exploration is thus required in order to ensure correct diagnosis and treatment. Among the numerous treatments used in application to trigger points, the spray-and-stretch technique and direct injection targeted to such trigger points have been found to be the most effective options. In chronic cases, psychosocial intervention is required, due to the high incidence of mood disorders and/or anxiety observed in these patients, who in turn present a poorer prognosis. This underscores the importance of early diagnosis and treatment.

Orofacial pain of cardiac origin, serial of clinical cases

Objective: To determine the clinical characteristics of the orofacial pain of cardiac origin in patients visited when doing a treadmill exercise test, at the cardiology service of the Can Ruti Hospital in Badalona (Barcelona, Spain). Study design: The sample of that study included thirty patients visiteding when doing a treadmill exercise test, at the cardiology service. The questionnaire has been asked to a sample of 30 patients. Results: Eleven of the 30 patients included in this study presented craniofacial pain before or during the cardiac seizure. The location of the pain was bilateral, non-irradiated at the mandible in all cases. The intensity of the pain was from slight to severe. The frequency of the appearance of the pain was paroxysmal in 8 cases and constant in three cases, and the duration was from a few hours to a maximum of 14 days. Discussion: The cardiac pain in craniofacial structures is usually bilateral, compared to odontogenic pain which is always unilateral. The pain of cardiac origin is considered atypical because of its location, but about the 10 % of the cases, the cardiac ischemia has its primary manifestation in orofacial structures. Conclusions: Eleven patients referred a bilateral non-irradiated mandibular pain, with intensity from slight to severe, and with a paroxystic frequency in eight cases and a constant frequency in three cases. Just one patient referred pain during the treadmill exercise test. In all cases the pain disappeared after the cardiac surgery or the administration of vasodilators.

Ergonomics and musculoskeletal pain among postgraduate students and faculty members of the School of Dentistry of the University of Barcelona (Spain). A cross-sectional study

Objectives: To evaluate the intensity and location of musculoskeletal pain suffered by students and professors from different postgraduate programs of the School of Dentistry of the University of Barcelona (Spain), to identify the variables related to the occurrence of musculoskeletal symptoms and signs, and to establish possible preventive measures for such disorders. Materials and Methods: A cross-sectional study was made among students and faculty members from different postgraduate courses of the School of Dentistry at the University of Barcelona between May and June 2007. A total of 74 dentists (54 postgraduate students and 20 faculty members) completed an anonymous questionnaire containing 19 questions. The variables were divided into three main groups: sociodemographic information, ergonomic features and musculoskeletal pain arising from professional practice. Results: Most of the dentists (79.8%) had experienced some kind of musculoskeletal pain in the last 6 months. On comparing the different locations of pain (lumbar, cervical, dorsal, wrist, shoulder and others), the neck was found to be the most commonly affected location (58% of all subjects), and only 34% of the respondents took some preventive measures against musculoskeletal disorders. Women showed a higher frequency of intense pain involving the cervical, lumbar, dorsal and wrist areas (p<0.05). A higher incidence of wrist pain was recorded in professionals exclusively dedicated to oral surgery (p<0.05). No statistically significant correlation was found between the workload (hours) and pain in the different anatomical locations (p>0.05). Conclusions: An important incidence of pain symptoms secondary to musculoskeletal disorders was observed, particularly in the cervical region. Females and younger dentists showed a higher frequency of such symptoms. The implementation of preventive measures is necessary, in view of the high incidence of these disorders

El Théâtre de La Mie de Pain, un exemple del teatre de l’actor-creador

L’autora del treball, Élisabeth Cauchetiez, va formar part del grup Théâtre de La Mie de Pain des del setembre 1979 al febrer 1989, La intenció de la recerca és de fer de l’experiència subjectiva un objecte d’observació. Desprès de definir què és el teatre de l’actor creador, en un moment de la història del teatre on la creació col•lectiva va assolir la dimensió de fascinació. fa esment als fonaments sociològics del Théâtre de La Mie de Pain i analitza les programacions dels festivals i gires, així com la recepció que la crítica teatral va fer dels seus espectacles. Explica el procés d’elaboració dels espectacles : “Blanche-Neige au royaume de Fantochie”, “Séance-Friction”, “Seul ... Les requins ! “, “Terminus Hôpital ” i “Starjob”.

Recomanacions per defensar l’informe al judici oral

L'equip de la comunitat d'assessorament tècnic penal s'ha aplegat, en aquesta ocasió,per elaborar una guia de bones pràctiques en l’exercici de la tasca pericial en la situació de judici oral. És a dir, un manual que ajudi a identificar els elements que cal posar en joc per contestar la pregunta clau de tot peritatge: és creïble, el relat?, i que alhora doni pistes clares sobre com presentar el resultat d’aquesta feina.

The effects of teacher talk on students’ oral productions

The present study is a brief personal enquiry into the teaching and learning of EFL in the classroom with an orientation to action and personal professional development. It focuses on teacher talk, making special emphasis on questions, as well as on students’ resulting oral productions. The research contains samples of empirical data, which include their interpretations in the light of relevant research literature, and a more personal overall reflection of the teaching practice. Both the analysis and the reflections derive to a large extent from the self-observation paper 1 (SO1) and the Practicum portfolio (PP) developed within the TED Masters Degree practicum stages

Analyzing complexity in foreign language monologic oral production in a CLIL context

The study tested three analytic tools applied in SLA research (T-unit, AS-unit and Idea-unit) against FL learner monologic oral data. The objective was to analyse their effectiveness for the assessment of complexity of learners' academic production in English. The data were learners' individual productions gathered during the implementation of a CLIL teaching sequence on Natural Sciences in a Catalan state secondary school. The analysis showed that only AS-unit was easily applicable and highly effective in segmenting the data and taking complexity measures

Implementing CLIL in a primary school in Spain : the effects of CLIL on L2 English learners' oral production skills

This study presents the results of implementing a CLIL programme in a Catalan primary school three years after the onset of the implementation. The main objective of this investigation was to determine the effects of CLIL on students’ L2 English oral performance in terms of Complexity, Accuracy and Fluency (CAF). The results obtained suggest that CLIL learners outperform non-CLIL learners not only in fluency, but also in syntactic complexity. However, despite the encouraging results, the study concludes that further research which transcends the methodological limitations observed in the study is needed in order to confirm the results

Ciclofosfamida oral metronómica en combinación con prednisona tras la progresión a docetaxel en pacientes afectados de un cáncer de próstata metastásico resistente a la castración (CPRC).

Estudi retrospectiu que avalua eficàcia i tolerabilitat de ciclofosfamida oral metronòmica (COM) més prednisona en CPRC com a segona línia de tractament després de la progressió a docetaxel. Quinze pacients foren tractats. L'objectiu principal fou eficàcia del tractament. Els objectius secundaris eren toxicitat, període lliure de progressió (PLP) i supervivència global (SG). La resposta parcial per PSA es va evidenciar en 33.3%. La mitjana del PLP i SG van ser de 4.1 mesos i 7.2 mesos respectivament. La principal toxicitat va ser l'astènia. COM és poc tòxica i pot ser una alternativa en aquells malalts amb mal estat

Incidencia y gravedad de la enfermedad por citomegalovirus en pacientes trasplantados renales que han recibido tratamiento anticipado o profilaxis con valganciclovir oral

Antecedentes: La infección por CMV es la más frecuente que sufren los receptores de trasplante de órgano sólido (TOS) en los primeros meses del trasplante. Son abundantes las estrategias de prevención y tratamiento de la enfermedad por CMV que se han desarrollado. Métodos: El objetivo fue evaluar la incidencia y severidad de la enfermedad por CMV en 387 receptores de trasplante renal que recibieron tratamiento profiláctico (grupo de alto riesgo, n = 251) o realizaron seguimiento de PCR de CMV por ser grupo de bajo riesgo (n = 136) y recibieron tratamiento anticipado (n = 17) con valganciclovir oral (900 mg/día) cuando presentaron & 1000 copias/ml. Resultados: Presentaron enfermedad por CMV, 2 (11,76%) pacientes del grupo de riesgo estándar, descrita como enfermedad leve y 20 (7,96%) pacientes del grupo de alto riesgo, descrita como enfermedad leve en 15 casos y como enfermedad grave en 5 casos. Aquellos pacientes que desarrollaron la enfermedad, respondieron al tratamiento con ganciclovir endovenoso durante 14 días seguido de valganciclovir oral hasta completar tres meses. Conclusión: El tratamiento profiláctico con valganciclovir oral para la prevención de enfermedad o infección por CMV solamente es necesario en los receptores de TOS de alto riesgo.

La tradició oral africana lluny del seu context d'origen : estudi sobre la vigència i funcions de les històries orals senegaleses a l'àrea de Barcelona

La recerca vol determinar, principalment, si continua donant-se i sent vàlida la transmissió de la cultura oral de l'Àfrica occidental fora del seu context originari, en el cas concret del col·lectiu senegalès a l'àrea de Barcelona.