Cambios Clínicos e Imagenológicos en Terapias no Invasivas en Articulaciones Temporomandibulares con Alteraciones Óseas Degenerativas / Clinical and Imaging Changes with Non-Invasive Therapies in Temporomandibular Joints with Degenerative Joint Disease

El objetivo del presente estudio fue describir los cambios clínicos e imagenológicos de las terapias no invasivas aplicadas a pacientes con alteraciones óseas degenerativas de las articulaciones temporomandibulares (ATM). Metodología: Se evaluaron 25 pacientes con alteraciones óseas degenerativas de las ATM, sin tratamiento previo de trastornos temporomandibulares (TTM) al momento del diagnóstico. Se realizó tratamiento no invasivo y un año después fueron evaluados según criterios clínicos e imagenológicos DC/TMD y Ahmad. Los resultados fueron presentados por medio de estadística descriptiva, odds ratio con sus respectivos intervalos de confianza, comparaciones de medianas y correlaciones. Se estudiaron 50 ATM, 72 % mujeres (32,2 años promedio). Se observó mejora significativa en los parámetros: dolor (p=0,0001), sinovitis (p=0,001) e incremento de la esclerosis del trabeculado óseo (p=0,051) a un año post-tratamiento. Después de un año del establecimiento de terapias no invasivas en pacientes con alteraciones óseas degenerativas de las ATM, se observaron cambios positivos tanto clínicos como imagenológicos, reduciéndose significativamente la sintomatología dolorosa, limitándose la progresión del daño óseo degenerativo, y observándose recuperación de los casos de sinovitis.

The objective of this study was to describe clinical and imaging changes of non-invasive therapies applied to patients with degenerative bone disorders of the temporomandibular joints (TMJ). To carry out this study, 25 patients with degenerative bone disorders of TMJ without previous treatment at the time of diagnosis, were evaluated. Non-invasive treatment was performed and one year later they were evaluated according to clinical and imaging criteria DC/TMD and Ahmad. Results were presented by descriptive statistics, odds ratio, confidence interval, comparisons of means, and correlations. 50 TMJs, 72 % women, (32.2 years mean of age) were studied. Significant improvement was observed in the parameters: pain (p=0.0001), synovitis (p=0.001), and increased sclerosis of the bone trabeculae (p=0,051) at one-year post-treatment. After one year of the establishment of non-invasive therapies in patients with degenerative joint disease of TMJ, it was observed positive changes, both clinical and imaging, reducing painful symptomatology, limiting effect on the progression of degenerative bone damage, and recovery of synovitis cases.

Repetitive transcranial magnetic stimulation of the prefrontal cortex for fibromyalgia syndrome: a randomised controlled trial with 6-months follow up

Abstract Objectives Fibromyalgia Syndrome (FMS), is a chronic pain disorder with poorly understood pathophysiology. In recent years, repetitive transcranial magnetic stimulation (rTMS) has been recommended for pain relief in various chronic pain disorders. The objective of the present research was to study the effect of low frequency rTMS over the right dorsolateral prefrontal cortex (DLPFC) on pain status in FMS. Methods Ninety diagnosed cases of FMS were randomized into Sham-rTMS and Real-rTMS groups. Real rTMS (1 Hz/1200 pulses/8 trains/90% resting motor threshold) was delivered over the right DLPFC for 5 consecutive days/week for 4 weeks. Pain was assessed by subjective and objective methods along with oxidative stress markers. Patients were followed up for 6 months (post-rTMS;15 days, 3 months and 6 months). Results In Real-rTMS group, average pain ratings and associated symptoms showed significant improvement post rTMS. The beneficial effects of rTMS lasted up to 6 months in the follow-up phase. In Sham-rTMS group, no significant change in pain ratings was observed. Conclusion Right DLPFC rTMS can significantly reduce pain and associated symptoms of FMS probably through targeting spinal pain circuits and top-down pain modulation . Trial registration: Ref No: CTRI/2013/12/004228.(AU)

Clinical study of invasive and non-invasive therapy in treatment of otitis media with effusion / 中国医师进修杂志

Objective To compare the clinical effects of invasive and non-invasive therapy in treatment of otitis media with effusion. Methods Seventy-six patients (94 ears) with otitis media with effusion were divided into two groups by random digits table. The invasive group (38 cases, 48 ears) was treated by oto-endoscopic myringotomy and grommet insertion and chymotrypsin with dexamethasone washing for 1-2 times; and the non-invasive group (38 cases, 46 ears) was treated by eustachian tube blowing under nasal endoscopy and injecting chymotrypsin and dexamethasone for 1-2 times. The clinical effects between the two groups were compared. Results The patients were followed up for 6-12 months. The total effective rate was 95.8%(46/48) in the invasive group and 93.5%(43/46) in the non-invasive group, the difference was not statistically significant (P ＞ 0.05 ). The ear pressure chart recovery time was (37.5 ± 5.9) d in the invasive group and (38.6 ± 6.1 ) d in the non-invasive group, the difference was not statistically significant (P ＞ 0.05 ). The pure tone audiometry hearing improved ( 20.4 ± 2.7 ) dB in the invasive group and ( 19.9 ±2.5) dB in the non-invasive group, the difference was not statistically significant (P ＞ 0.05 ). Conclusion Both of invasive and non-invasive therapy in treatment of otitis media with effusion have good results, the doctors should choose the appropriate solution according to the patients' condition.