Piroxicam and laser phototherapy in the treatment of TMJ arthralgia: a double-blind randomised controlled trial.

This study aimed to evaluate the efficacy of piroxicam associated with low-level laser therapy compared with single therapies in 32 patients presenting temporomandibular joint arthralgia in a random and double-blind research design. The sample, divided into laser + piroxicam, laser + placebo piroxicam and placebo laser + piroxicam groups, was submitted to the treatment with infrared laser (830 nm, 100 mW, 28 s, 100 J cm(-2) ) at 10 temporomandibular joint and muscle points on each side during four sessions concomitant to take one capsule a day of piroxicam 20 mg during 10 days. The treatment was evaluated throughout four sessions and 30 days follow-up through visual analogue scale (VAS), maximum mouth opening and joint and muscle (temporal and masseter) pain on palpation. The results showed that all the study groups had a significant improvement in the VAS scores (P < 0·05), and there were no significant group differences. Piroxicam was effective in the reduction of joint and muscle pain on palpation (P < 0·05) and showed the lowest temporal pain (P = 0·02) at the 30-day follow-up. The combination of low-level laser therapy and piroxicam was not more effective than single therapies in the treatment of temporomandibular joint arthralgia. The use of piroxicam was more effective in the following 30 days.

An fMRI investigation on image generation in different sensory modalities: the influence of vividness.

In the present fMRI study the issue of the specific cortices activation during imagery generation in different sensory modalities is addressed. In particular, we tested whether the vividness variability of imagery was reflected in the BOLD signal within specific sensory cortices. Subjects were asked to generate a mental image for each auditory presented sentence. Each imagery modality was contrasted with an abstract sentence condition. In addition, subjects were asked to fill the Italian version of the Questionnaire Upon Mental Imagery (QMI) prior to each neuroimaging session. In general, greater involvement of sensory specific cortices in high-vivid versus low-vivid subjects was found for visual (occipital), gustatory (anterior insula), kinaesthetic (pre-motor), and tactile and for somatic (post-central parietal) imagery modalities. These results support the hypothesis that vividness is related to image format: high-vivid subjects would create more analogical representations relying on the same specific neural substrates active during perception with respect to low-vivid subjects. Results are also discussed according to the simulation perspective.

Bone and maxillofacial abnormalities in thalassemia: a review of the literature.

Thalassemia is an inherited blood disorder due to an imbalanced globin chain synthesis leading to anaemia that requires regular blood transfusions and iron-chelating therapy. Of all organ failures secondary to iron deposit, and all the complications, heart failure still represents the first cause of death. Osteopenia and osteoporosis can be considered important causes of morbidity in a population whose lifespan is getting longer, with a strong impact on their quality of life. Authors have reported mainly bone, oral and maxillofacial abnormalities and relative complications, especially in terms of traumatic risk, in patients affected by thalassemia. As examples, this study reports bone modifications in three clinical cases; one of these was also complicated with a femoral fracture, surgically treated with the same criteria of metastatic femoral bone disease. More research on this topic is necessary for the prevention of several complications caused by this disease, and to carefully plan dental or traumatologic operations.

Isolated bone lesion secondary to hyperparathyroidism: diagnostic considerations.

Authors describe two cases of bone lesions ("brown" tumour) secondary to hyperparathyroidism in whom incisional biopsy gave an incorrect diagnosis. The first case was a patient with a lesion of the right femur diagnosed as aneurismal cyst and; the second case was a patient with an isolated lesion of the distal metaphysic of right humerus firstly diagnosed as giant cells tumour. Treatment of the first case was resection and diaphyseal spacer, and the correct diagnosis of brown tumour was performed for the multiple tibial localizations appeared six months later. The second case was diagnosed as affected by a brown tumour secondary to hyperparathyroidism on the basis of clinical history and laboratory analysis. Both diagnoses were firstly incorrect and would have brought to an inadequate treatment with consequences on patients quality life. Differential diagnosis is discussed and the importance to evaluate all the diagnostic data to formulate a correct diagnosis is stressed.

Subtrochanteric femoral fracture in a 26 year old woman affected by beta-thalassemia major due to minor trauma: analysis of bone modification causing the complication.

Beta-Thalassemia Major (TM), firstly described by Cooley, is and inherited blood disorder that leads to anaemia due to an imbalanced globin chain synthesis effecting erythroid maturation and red cells survival and requests regular life-long blood transfusions and iron-chelating therapy. Among all the complications and organ diseases, osteopenia and osteoporosis, as progressive diseases are getting important cause of morbidity in a population whose longevity is increasing. The authors describe a case of a 26-year-old female with Beta-Thalassemia Major affected by a subtrochanteric fracture of the right femur on minor trauma. Cardiovascular, endocrinologic and thrombotic pattern leading to bone modifications are reported and Literature reviewed. Fracture was surgically treated with anterograde reconstructive intramedullary locked nail (AFN, Synthes) with 2 distal screws inserted in a static mode.

"What" versus "where" in the audiovisual domain: an fMRI study.

Similar "what/where" functional segregations have been proposed for both visual and auditory cortical processing. In this fMRI study, we investigated if the same segregation exists in the crossmodal domain, when visual and auditory stimuli have to be matched in order to perform either a recognition or a localization task. Recent neuroimaging research highlighted the contribution of different heteromodal cortical regions during various forms of crossmodal binding. Interestingly, crossmodal effects during audiovisual speech and object recognition have been found in the superior temporal sulcus, while crossmodal effects during the execution of spatial tasks have been found over the intraparietal sulcus, suggesting an underlying "what/where" segregation. In order to directly compare the specific involvement of these two heteromodal regions, we scanned ten male right-handed subjects during the execution of two crossmodal matching tasks. Participants were simultaneously presented with a picture and an environmental sound, coming from either the same or the opposite hemifield and representing either the same or a different object. The two tasks required a manual YES/NO response respectively about location or semantic matching of the presented stimuli. Both group and individual subject analysis were performed. Task-related differences in BOLD response were observed in the right intraparietal sulcus and in the left superior temporal sulcus, providing a direct confirmation of the "what-where" functional segregation in the crossmodal audiovisual domain.

Does testing for prostate-specific antigen contribute to declining prostate cancer mortality? Estimating the broader economic influences on aggregate prostate cancer mortality rates.

Key variables associated with prostate cancer mortality were examined using Canadian province level time-series data over the period 1979-1999 in a multiple regression framework. The key variables driving the prostate cancer mortality rate are per capita income, per capita number of family physicians, rate of prostate cancer incidence, real per capita total health spending, and a time trend. As well, provincial dummy variables show that regional differences exist with higher rates of mortality in eastern Canada. Econometric results show a positive and significant relationship between incidence and mortality, suggesting that the increased amount of prostate-specific antigen (PSA) testing may not have been responsible for mortality declines. However, there is also a downward trend in mortality from prostate cancer when all other factors are controlled for that can be attributed partly to the onset of PSA testing given that the benefits should emerge over time. A 1% increase in incidence is associated with a 0.2% increase in mortality. A 1% increase in real per capita income is associated with a 0.5% increase in mortality when real per capita income is below Canadian dollars 20,054. A 1% increase in the per capita number of family physicians reduces the mortality rate by 0.5%. A 1% increase in real per capita total health expenditures is associated with a 0.7% decline in the mortality rate. Finally, by 1999 there were 4.74 fewer deaths per 100,000 population due to the effect of time after controlling for all other factors--a decrease of approx. 15%.

Selection of bacteriophage-resistant mutants of Streptococcus thermophilus.

Phage-resistant mutants have been isolated from Streptococcus thermophilus. Selection was carried out using anti-phage antibodies or Hoechst 33258-labelled phages. Two mutants out of eight tested displayed reduced acidifying capacity. Selection of the bacteria that extruded more rapidly the fluorochrome 5-6-carboxyfluorescein diacetate (CFDA) restored the acidifying capacity of these two mutants to the level of the parental strains. Mutants displaying phage resistance and good acidifying capacity were obtained in 4-5 days. New phages that are able to overcome the protection mechanisms of the existing bacteria arise continually in the dairy environment. The procedures described here permit to replace promptly the starter culture susceptible to newly emerged phages with a resistant one.

Evidence on the determinants of Canadian provincial government health expenditures: 1965-1991.

Real per capital provincial government expenditures on health care over the period 1965-1991 are examined using pooled time-series cross-section regression analysis: Key determinants of real per capita provincial government expenditures on health care over the period 1965-1991 are real provincial per capita income, the proportion of the provincial population over age 65 and real provincial per capita federal transfer revenues. Established program financing had a negative and significant impact on real per capita provincial government health expenditures in Newfoundland and Quebec. An income elasticity of 0.77 implies that health care is not a luxury good.