A baseline assessment of the relationship between microplastics and plasticizers in sediment samples collected from the Barcelona continental shelf.

It has been suggested that the seafloor may be a sink for the plastic debris that enters the ocean. Therefore, the collection of data in the seafloor sediments regarding the co-presence of microplastics (MPs) and contaminants associated to plastic is considered a relevant topic. However, the number of studies addressing their possible correlation in this environment is still limited, and very little is known about the mechanisms that determine the release of plastic additives from plastic items. Starting from this basis, we investigated the presence of MPs and eleven phthalic acid esters (PAEs) in the continental shelf offshore Barcelona. Following a shelf-slope continuum approach, we sampled sediments from five stations, and we performed analysis by means of infrared micro spectroscopy (µFTIR) and liquid chromatography tandem mass spectrometry (LC-MS/MS). MPs were found to range from 62.0 to 931.1 items/kg d.w. with maximum concentration in the submarine canyon Besòs and at the highest depth. Moreover, different trends in the size distribution of fibers and non-fibers were observed, indicating the occurrence of a size dependent selection mechanism during transport and accumulation. PAEs resulted comprised between 1.35 to 2.41 mg/kg with Di(2-ethylhexyl)phthalate (DEHP) the most abundant congeners (1.04 mg/kg). Statistical analysis revealed no correlation between the Σ11PAEs and the total MPs concentration, but correlation between DEHP and fibers (σ = 0.667, p = 0,037), that resulted both correlated to the distance to the coast (ρ = 0.941 with p = 0,008 and ρ = 0.673 with p = 0.035, respectively).

Airborne and marine microplastics from an oceanographic survey at the Baltic Sea: An emerging role of air-sea interaction?

Microplastics (MPs) pollution is one of the most important problems of the Earth. They have been found in all the natural environments, including oceans and the atmosphere. In this study, the concentrations of both atmospheric and marine MPs were measured over the Baltic along a research cruise that started in the Gdansk harbour, till the Gotland island, and the way back. A deposition box (based on a combination of active/passive sampling) was used to collect airborne MPs while, marine MPs concentrations were investigated during the cruise using a dedicated net. Ancillary data were obtained using a combination of particle counters (OPC, LAS and CPC), Aethalometer (AE33 Magee Scientific), spectrofluorometer (sea surface samples, Varian Cary Eclipse), and meteorological sensors. Results showed airborne microplastics average concentrations higher in the Gdansk harbour (161 ± 75 m-3) compared to the open Baltic Sea and to the Gotland island (24 ± 9 and 45 ± 20 m-3). These latter values are closer to the ones measured in the sea (79 ± 18 m-3). The MPs composition was investigated using µ-Raman (for the airborne ones) and FTIR (for marine ones); similar results (e.g. polyethylene, polyethylene terephthalates, polyurethane) were found in the two environmental compartments. The concentrations and similar composition in air and sea suggested a linkage between the two compartments. For this purpose, the atmospheric MPs' equivalent aerodynamic diameter was calculated (28 ± 3 µm) first showing the capability of atmospheric MPs to remain suspended in the air. At the same time, the computed turnover times (0.3-90 h; depending on MPs size) limited the transport distance range. The estimated MPs sea emission fluxes (4-18 ∗ 106 µm3 m-2 s-1 range) finally showed the contemporary presence of atmospheric transport together with a continuous emission from the sea surface enabling a grasshopper long-range transport of microplastics across the sea.

Leonardo da Vinci's "Last Supper": a case study to evaluate the influence of visitors on the Museum preservation systems.

The most important parameter to obtain an appropriate preservation condition of museum environments concerns the indoor air quality. The exposure of artwork and materials to gaseous and particulate pollutants introduced by visitors and either indoor or outdoor sources contributes to their decay. In this work, we evaluated the possible monitoring of the visitors' influence using the stable carbon isotopic ratio of CO2 and the concentration of NH3 as a real-time tool. The study was done in the Refectory of Santa Maria delle Grazie (Milan, Italy) which houses one of the most important paintings of Leonardo da Vinci, the Last Supper, and had more than 400,000 visitors in 2019. The results confirmed a good correlation between the presence of tourists inside the museum and the variation of δ13C value during the visits and the closure of the museum. The variation of indoor atmospheric δ13C was influenced by the presence of visitors in the Refectory and delineates the way done from the entrance to the exit. In the same way, the concentration of NH3 was influenced by the presence of visitors and confirmed the role of this one on preservation methodology for indoor air quality in the museum. This new methodology can be used as a supplemental and non-invasive tool to help in calibrating microclimatic conditions through the ventilation rate and air filtration systems in the museum and to manage the number of visitors per turn.

Ultrafine particles and PM2.5 in the air of cities around the world: Are they representative of each other?

Can mitigating only particle mass, as the existing air quality measures do, ultimately lead to reduction in ultrafine particles (UFP)? The aim of this study was to provide a broader urban perspective on the relationship between UFP, measured in terms of particle number concentration (PNC) and PM2.5 (mass concentration of particles with aerodynamic diameter < 2.5 µm) and factors that influence their concentrations. Hourly average PNC and PM2.5 were acquired from 10 cities located in North America, Europe, Asia, and Australia over a 12-month period. A pairwise comparison of the mean difference and the Kolmogorov-Smirnov test with the application of bootstrapping were performed for each city. Diurnal and seasonal trends were obtained using a generalized additive model (GAM). The particle number to mass concentration ratios and the Pearson's correlation coefficient were calculated to elucidate the nature of the relationship between these two metrics. Results show that the annual mean concentrations ranged from 8.0 × 103 to 19.5 × 103 particles·cm-3 and from 7.0 to 65.8 µg·m-3 for PNC and PM2.5, respectively, with the data distributions generally skewed to the right, and with a wider spread for PNC. PNC showed a more distinct diurnal trend compared with PM2.5, attributed to the high contributions of UFP from vehicular emissions to PNC. The variation in both PNC and PM2.5 due to seasonality is linked to the cities' geographical location and features. Clustering the cities based on annual median concentrations of both PNC and PM2.5 demonstrated that a high PNC level does not lead to a high PM2.5, and vice versa. The particle number-to-mass ratio (in units of 109 particles·µg-1) ranged from 0.14 to 2.2, >1 for roadside sites and <1 for urban background sites with lower values for more polluted cities. The Pearson's r ranged from 0.09 to 0.64 for the log-transformed data, indicating generally poor linear correlation between PNC and PM2.5. Therefore, PNC and PM2.5 measurements are not representative of each other; and regulating PM2.5 does little to reduce PNC. This highlights the need to establish regulatory approaches and control measures to address the impacts of elevated UFP concentrations, especially in urban areas, considering their potential health risks.

Heating Rate of Light Absorbing Aerosols: Time-Resolved Measurements, the Role of Clouds, and Source Identification.

Light absorbing aerosols (LAA) absorb sunlight and heat the atmosphere. This work presents a novel methodology to experimentally quantify the heating rate (HR) induced by LAA into an atmospheric layer. Multiwavelength aerosol absorption measurements were coupled with spectral measurements of the direct, diffuse and surface reflected radiation to obtain highly time-resolved measurements of HR apportioned in the context of LAA species (black carbon, BC; brown carbon, BrC; dust), sources (fossil fuel, FF; biomass burning, BB), and as a function of cloudiness. One year of continuous and time-resolved measurements (5 min) of HR were performed in the Po Valley. We experimentally determined (1) the seasonal behavior of HR (winter 1.83 ± 0.02 K day-1; summer 1.04 ± 0.01 K day-1); (2) the daily cycle of HR (asymmetric, with higher values in the morning than in the afternoon); (3) the HR in different sky conditions (from 1.75 ± 0.03 K day-1 in clear sky to 0.43 ± 0.01 K day-1 in complete overcast); (4) the apportionment to different sources: HRFF (0.74 ± 0.01 K day-1) and HRBB (0.46 ± 0.01 K day-1); and (4) the HR of BrC (HRBrC: 0.15 ± 0.01 K day-1, 12.5 ± 0.6% of the total) and that of BC (HRBC: 1.05 ± 0.02 K day-1; 87.5 ± 0.6% of the total).

Chemically and size-resolved particulate matter dry deposition on stone and surrogate surfaces inside and outside the low emission zone of Milan: application of a newly developed "Deposition Box".

The collection of atmospheric particles on not-filtering substrates via dry deposition, and the subsequent study of the particle-induced material decay, is trivial due to the high number of variables simultaneously acting on the investigated surface. This work reports seasonally resolved data of chemical composition and size distribution of particulate matter deposed on stone and surrogate surfaces obtained using a new method, especially developed at this purpose. A "Deposition Box" was designed allowing the particulate matter dry deposition to occur selectively removing, at the same time, variables that can mask the effect of airborne particles on material decay. A pitched roof avoided rainfall and wind variability; a standardised gentle air exchange rate ensured a continuous "sampling" of ambient air leaving unchanged the sampled particle size distribution and, at the same time, leaving quite calm condition inside the box, allowing the deposition to occur. Thus, the "Deposition Box" represents an affordable tool that can be used complementary to traditional exposure systems. With this system, several exposure campaigns, involving investigated stone materials (ISMs) (Carrara Marble, Botticino limestone, Noto calcarenite and Granite) and surrogate (Quartz, PTFE, and Aluminium) substrates, have been performed in two different sites placed in Milan (Italy) inside and outside the low emission zone. Deposition rates (30-90 µg cm-2 month-1) showed significant differences between sites and seasons, becoming less evident considering long-period exposures due to a positive feedback on the deposition induced by the deposited particles. Similarly, different stone substrates influenced the deposition rates too. The collected deposits have been observed with optical and scanning electron microscopes and analysed by ion chromatography. Ion deposition rates were similar in the two sites during winter, whereas it was greater outside the low emission zone during summer and considering the long-period exposure. The dimensional distribution of the collected deposits showed a significant presence of fine particles in agreement with deposition rate of the ionic fraction. The obtained results allowed to point out the role of the fine particles fraction and the importance of making seasonal studies.

Nitration of pollen aeroallergens by nitrate ion in conditions simulating the liquid water phase of atmospheric particles.

Pollen aeroallergens are present in atmospheric particulate matter (PM) where they can be found in coarse biological particles such as pollen grains (aerodynamic diameter dae>10µm), as well as fragments in the finest respirable particles (PM2.5; dae<2.5µm). Nitration of tyrosine residues in pollen allergenic proteins can occur in polluted air, and inhalation and deposition of these nitrated proteins in the human respiratory tract may lead to adverse health effects by enhancing the allergic response in population. Previous studies investigated protein nitration by atmospheric gaseous pollutants such as nitrogen dioxide and ozone. In this work we report, for the first time, a study on protein nitration by nitrate ion in aqueous solution, at nitrate concentrations and pH conditions simulating those occurring in the atmospheric aerosol liquid water phase. Experiments have been carried out on the Bovine serum albumin (BSA) protein and the recombinant Phleum pratense allergen (Phl p 2) both in the dark and under UV-A irradiation (range 4-90Wm-2) to take into account thermal and/or photochemical nitration processes. For the latter protein, modifications in the allergic response after treatment with nitrate solutions have been evaluated by immunoblot analyses using sera from grass-allergic patients. Experimental results in bulk solutions showed that protein nitration in the dark occurs only in dilute nitrate solutions and under very acidic conditions (pH<3 for BSA; pH<2.2 for Phl p 2), while nitration is always observed (at pH0.5-5) under UV-A irradiation, both in dilute and concentrated nitrate solutions, being significantly enhanced at the lowest pH values. In some cases, protein nitration resulted in an increase of the allergic response.

Efficacy of a workplace relaxation exercise program on muscle tenderness in a working community with headache and neck pain: a longitudinal, controlled study.

BACKGROUND: Pericranial muscle tenderness shows a remarkable prevalence not only in tension-type headache, but also in migraine, both episodic and chronic. Neck pain is a common disorder and leads to a high rate of work disability; its prevalence increases for headache. AIM: This study aimed at examining the effects of a relaxation exercise programme on pericranial/cervical muscle tenderness in a working community with headache and neck pain. DESIGN: This was a controlled, non-randomized trial. SETTING: The study was carried out in a working community, on the employees of the City of Turin's central and peripheral registry and tax offices. POPULATION: A total of 384 workers were enrolled and divided into two groups: a study group (group 1; 192 subjects) and a control group (group 2; 192 subjects). METHODS: A programme, with relaxation/posture exercises and a visual feedback, was carried out for Group 1 for 6 months and, afterwards, also for group 2 for the same follow-up period throughout. Data on head/neck pain were collected. Standard palpation of pericranial and cervical muscles was done, scoring each patient for Pericranial Muscle Tenderness (PTS) (0-3), Cervical Muscle Tenderness (CTS) (0-3) and a Cumulative Muscle Tenderness (CUM) (0-6). RESULTS: After 6 months from baseline, a significant difference was observed between the groups: i.e. group 1 had an average change from baseline of -0.19 for PTS, -0.2 for CTS and -0.36 for the CUM score - in association with a reduction in headache, neck and shoulder pain. The difference between the groups in PTS, CTS and CUM scores was no longer detectable at the end of the study, after also group 2 performed the programme. CONCLUSIONS: The administration of a workplace relaxation exercise intervention significantly decreased pericranial/cervical muscle tenderness in the working community, in association with head-neck pain benefit. CLINICAL REHABILITATION IMPACT: This relaxation exercise programme was remarkably cost-effective, yielding a relevant benefit on pericranial/cervical muscle tenderness in a working community, at a relatively low cost.

A split-mouth randomized clinical trial to evaluate the performance of piezosurgery compared with traditional technique in lower wisdom tooth removal.

PURPOSE: The surgical removal of mandibular third molars is frequently accompanied by significant postsurgical sequelae, and different protocols have been described to decrease such adverse events. The aim of this study was to investigate the performance of piezosurgery compared with traditional rotating instruments during mandibular third molar removal. PATIENTS AND METHODS: A single-center, randomized, split-mouth study was performed using a consecutive series of unrelated healthy patients attending the Oral Surgery Unit of the University of Turin for surgical removal of bilateral mandibular third molar teeth. Each patient was treated, at the same appointment, using bur removal on 1 side of the mandible and a piezoelectric device on the contralateral side. The primary outcomes reported were postoperative pain, objective orofacial swelling, and surgical duration; secondary outcomes were gender, age, and possible adverse events. Analysis of variance or paired t test was used as appropriate to test any significant differences at baseline according to each treatment subgroup, and categorical variables were analyzed by χ(2) test. RESULTS: The study sample consisted of 100 otherwise healthy patients. The mean pain evaluation reported by patients who underwent surgery with piezosurgery was significantly lower than that reported after bur (conventional) removal, reaching statistical difference after 4 days (P = .043). The clinical value of orofacial swelling at day 7, normalized to baseline, was lower in the piezosurgery group (P < .005). The average surgical duration was significantly shorter in the bur group than in the piezosurgery group (P < .05). Three patients having bur removal developed short-term complications (2 dry sockets and 1 temporary paraesthesia), which totally resolved by 4 weeks. CONCLUSIONS: To date, this prospective investigation is the largest reported split-mouth study on piezosurgery for lower third molar tooth removal. This study also compared surgeons with different degrees of experience. It is evident that using a piezoelectric device can enhance the patient experience and decrease postoperative pain and swelling.

Aerosol corrosion prevention and energy-saving strategies in the design of green data centers.

The energy demands of data centers (DCs) worldwide are rapidly increasing, as are their environmental and economic costs. This paper presents a study conducted at Sannazzaro de' Burgondi (Po Valley), Italy, specifically aimed at optimizing the operating conditions of a DC designed for the Italian Oil and Gas Company (Eni) (5200 m(2) of Information Technology installed, 30 MW) and based on a direct free cooling (DFC) system. The aim of the study was to save the largest possible quantity of energy, while at the same time preventing aerosol corrosion. The aerosol properties (number size distribution, chemical composition, deliquescence relative humidity (DRH), acidity) and meteorological parameters were monitored and utilized to determine the potential levels of aerosol entering the DC (equivalent ISO class), together with its DRH. These data enabled us both to select the DC's filtering system (MERV13 filters) and to optimize the cooling cycle through calculation of the most reliable humidity cycle (60% of maximum allowed RH) applicable to the DFC. A potential energy saving of 81%, compared to a traditional air conditioning cooling system, was estimated: in one year, for 1 kW of installed information technology, the estimated energy saving is 7.4 MWh, resulting in 2.7 fewer tons of CO2 being emitted, and a financial saving of € 1100.

An educational and physical program to reduce headache, neck/shoulder pain in a working community: a cluster-randomized controlled trial.

BACKGROUND: Noninvasive physical management is often prescribed for headache and neck pain. Systematic reviews, however, indicate that the evidence of its efficacy is limited. Our aim was to evaluate the effectiveness of a workplace educational and physical program in reducing headache and neck/shoulder pain. METHODOLOGY/PRINCIPAL FINDINGS: Cluster-randomized controlled trial. All municipal workers of the City of Turin, Italy, were invited to participate. Those who agreed were randomly assigned, according to their departments, to the intervention group (IG) or to the control group and were given diaries for the daily recording of pain episodes for 1 month (baseline). Subsequently, only the IG (119 departments, 923 workers) began the physical and educational program, whereas the control group (117 departments, 990 workers) did not receive any intervention. All participants were again given diaries for the daily recording of pain episodes after 6 months of intervention. The primary outcome was the change in the frequency of headache (expressed as the proportion of subjects with a ≥50% reduction of frequency; responder rate); among the secondary outcomes there were the absolute reduction of the number of days per month with headache and neck/shoulder pain. Differences between the two groups were evaluated using mixed-effect regression models. The IG showed a higher responder rate [risk ratio, 95% confidence interval (CI)] for headache (1.58; 1.28 to 1.92) and for neck/shoulder pain (1.53; 1.27 to 1.82), and a larger reduction of the days per month (95% CI) with headache (-1.72; -2.40 to -1.04) and with neck/shoulder pain (-2.51; -3.56 to -1.47). CONCLUSIONS: The program effectively reduced headache and neck/shoulder pain in a large working community and appears to be easily transferable to primary-care settings. Further trials are needed to investigate the program effectiveness in a clinical setting, for highly selected patients suffering from specific headache types. TRIAL REGISTRATION: ClinicalTrials.gov NCT00551980.

Effectiveness of an educational and physical program in reducing accompanying symptoms in subjects with head and neck pain: a workplace controlled trial.

The objective of this study is to evaluate the effectiveness of an educational and physical program in reducing behavioral or somatic symptoms along with headache, neck and shoulder pain in a working community. A controlled, non-randomized trial was carried out in a working community and 384 employees were enrolled and divided into a study group (Group 1) and a control group (Group 2). The Group 1 received a physical and educational intervention, consisting of relaxation and posture exercises and the use of visual feedback. After 6 months, the intervention was administered to the Group 2. Both groups were then followed for an additional 6 months until the end of the trial. The presence of accompanying symptoms was investigated with a semi-structured interview using a checklist of 20 items, along with headache, neck, and shoulder pain parameters and the prevalence of generalized anxiety disorder and depression, in three clinical examinations at baseline, after 6 months and after 12 months. For each symptom, as well as the presence of any type of symptom, the differences between groups in the prevalence at the clinical examinations following the baseline were evaluated by applying logistic models. After 6 months, the probability of the presence of any type of symptom was significantly lower in the Group 1 (OR 0.69, 95% CI 0.56-0.85) with respect to the Group 2. After 12 months, the pooled estimation did not show any significant difference of symptom prevalence between groups (OR 0.80, 95% CI 0.64-1.00). In conclusion, this is the first longitudinal study relative to accompanying symptoms. Its results suggest the effectiveness of this cognitive program in reducing the burden of physical and psychiatric complaints in a large, working population.

Further evidence of the positive effects of an educational and physical program on headache, neck and shoulder pain in a working community.

In a controlled trial to evaluate the effectiveness of a simple educational and physical program administered to a large cohort of public servants, we previously found that 6 months following treatment the monthly frequency of headache and neck and shoulder pain and drug intake was reduced by 40% in the experimental compared with controls. These results were stable at a 12-month follow up. The program consists of brief shoulder and neck exercises to be performed several times a day, a relaxation exercise, and instructions on how to reduce parafunction and hyperfunction of the craniofacial and neck muscles during the day. The purpose of this work was to investigate whether the data previously obtained could be confirmed also in the group of 192 subjects that served as controls in first phase of the study and received the intervention in the second phase of the study. The primary endpoint was the change in frequency of headache and neck and shoulder pain expressed as the number of days per month with pain, and as the proportion of subjects with a ≥ 50% reduction of frequency (responder rate) at the last 2 months of the 6-month intervention period compared to the 2 months preceding the intervention (baseline). The number of days of analgesic drug consumption was also recorded. Days per month with headache at the baseline and at the end of intervention period were 6.40 and 4.58 (mean change -1.81, p < 0.0001), respectively; days with neck and shoulder pain were 7.48 and 6.18 (mean change -1.30, p = 0.0179); days of analgesic consumption were 1.67 and 1.17 (mean change -0.50, p = 0.0222). The responder rate was 42.3% for headache, 42% for neck and shoulder pain and 58.3% for drug consumption. In conclusion, this study adds further evidence on the efficacy of our program and its high acceptability in a large, unselected, working population.

Seasonal variations in chemical composition and in vitro biological effects of fine PM from Milan.

Fine particulate matter (PM1 and PM2.5) was collected in Milan over the summer (August-September) and winter (January-March) seasons of 2007/2008. Particles were analyzed for their chemical composition (inorganic ions, elements and PAHs) and the effects produced on the human lung carcinoma epithelial cell line A549. In vitro tests were performed to assess cell viability with MTT assay, cytokine release (IL-6 and IL-8) with ELISA, and DNA damage with COMET assay. Results were investigated by bivariate analysis and multivariate data analysis (Principal Component Analysis, PCA) to investigate the relationship between PM chemical composition and the biological effects produced by cell exposure to 12 microg cm(-2). The different seasonal chemical composition of PM showed to influence some biological properties. Summer PM samples had a high mass contribution of SO(4)(=) (13+/-2%) and were enriched in some elements, like Al, As, Cr, Cu, and Zn, compared to winter PM samples. Cell viability reduction was two times higher for summer PM samples in comparison with winter ones (27+/-5% and 14+/-5%, respectively), and the highest correlation coefficients between cell viability reduction and single chemical components were with As (R(2)=0.57) and SO(4)(=) (R(2)=0.47). PM1 affected cell viability reduction and induced IL-8 release, and these events were interrelated (R(2)=0.95), and apparently connected with the same chemical compounds. PM2.5 fraction, which was enriched in Ca(++) and Mg(++) (from soil dust), and Al, Fe, Zn, Ba Mn, produced cell viability reduction and DNA damage (R(2)=0.73).

The richest collection of tautomeric polymorphs: the case of 2-thiobarbituric acid.

Five new polymorphs and one hydrated form of 2-thiobarbituric acid have been isolated and characterised by solid-state methods. In both the crystalline form II and in the hydrate form, the 2-thiobarbituric molecules are present in the enol form, whereas only the keto isomer is present in crystalline forms I (reported in 1967 by Calas and Martinex), III, V and VI. In form IV, on the other hand, a 50:50 ordered mixture of enol/keto molecules is present. All new forms have been characterised by single-crystal X-ray diffraction, 1D and 2D ((1)H, (13)C, and (15)N) solid-state NMR spectroscopy, Raman spectroscopy and X-ray powder diffraction at variable temperature. It has been possible to induce keto-enol conversion between the forms by mechanical methods. The role of hydrogen-bond interactions in determining the relative stability of the polymorphs and as a driving force in the conversions has been ascertained. To the best of the authors' knowledge, the 2-thiobarbituric family of crystal forms represents the richest collection of examples of tautomeric polymorphism so far reported in the literature.

Personality profiles and subjective perception of pain in head pain patients.

Little or no information is available regarding the effect of the personality characteristics of headache sufferers on the quality of pain perception. The aim of this study is to investigate, in head pain sufferers, the relationship between the personality profile, assessed by the MMPI, and the different dimensions of pain (sensory, affective and evaluative), as assessed by the MPQ. Three hundred and seventeen patients with Migraine and/or tension-type headache (episodic or chronic) and myogenic facial pain were included. The Italian versions of the MMPI-2 and MPQ were administered, and the pain level was measured by the VAS. Cluster analysis based on the clinical scales of MMPI identified four personality profiles closely corresponding to the MMPI profiles obtained by the previous researchers: "depressive" (Dep.), "emotionally overwhelmed" (Emot.), "conversive" (Conv.) and "Coper". Differences in MPQ scales between personality profiles were investigated by means of a general linear model (GLM), adjusting for sex, age and pain level and type. Results of GLM analysis showed that the affective dimension was significantly higher in cluster Emot. than in Dep. (p=0.027), Conv. (p=0.002) and Coper (p=0.003). Total PRI was significantly higher in Emot. than in Conv. (p=0.010). The findings of the present study suggest that a specific personality profile (Emot.), characterized by a heavy emotional burden, may increase the affective dimension of pain with respect to a depressive profile (Dep.), a conversive profile (Conv.) or a normal profile (Coper), independent of sex, age and pain level and type.

Long-term benefits of an educational and physical program on headache, and neck and shoulder pain, in a working community.

UNLABELLED: We previously published the results of a controlled trial that showed the efficacy of a workplace educational and physical program in reducing headache, and neck and shoulder pain. Participants recorded daily pain episodes in diaries; after 2 months of baseline observation, the program was administered to the intervention arm only, and comparison with the control arm was performed at month 8. The objective of the present study was to confirm the long-term (14 months from the beginning of the study) benefit of the program in the intervention arm of the study (192 office employees). Outcome measures of the present analyses were: 1) the number of days/month with headache, and neck and shoulder pain; 2) the frequency of days with analgesic drug consumption; 3) the proportion of subjects with 4 or more days/month with headache or neck and shoulder pain at baseline who achieved a > or =50% reduction in pain (responder rate). Days/month with headache decreased from 5.50 at baseline (months 1-2) to 3.11 at months 13-14 (P < .001); from 6.79 to 3.88 (P < .001) for neck and shoulder pain; and from 1.72 to 0.86 (P < .001) for analgesic consumption. Responder rates were 58.8% (95%CI = 47.1-70.5) for headache, 60.9% (49.4-72.4) for neck and shoulder pain, and 68.2 % (48.7-87.6) for drug consumption. These results confirm that the program may be effective at long term. PERSPECTIVE: This article presents the results at long term of an educational and physical program in reducing headache, and neck and shoulder pain, in a working community. Since the benefits remained stable for a considerable period of time, a randomized trial is ongoing to confirm these results on a larger, less-selected working population.

Muscle tenderness in different types of facial pain and its relation to anxiety and depression: A cross-sectional study on 649 patients.

To evaluate in patients with different types of facial pain the association between muscle tenderness and a set of characteristics, 649 consecutive outpatients with facial myogenous pain (MP), TMJ disorder, neuropathic pain (NP) and facial pain disorder (FPD) (DSM-IV) were enrolled. For each patient a psychological assessment on the Axis 1 of the DSM-IV and standardized palpation of pericranial and cervical muscles were carried out. A pericranial muscle tenderness score (PTS), a cervical muscle tenderness score (CTS) and a cumulative tenderness score (CUM, range 0-6) were calculated. Univariate analyses (one-way analysis of variance or chi(2) test) indicated that both age- and sex-distribution, tenderness scores and prevalence of psychiatric disorders markedly differed between groups. The prevalence of depression was highest in FPD patients (44.9%). Both muscle tenderness scores (either PTS or CTS) and prevalence of anxiety were higher in patients with MP than in those with TMJ or NP. To assess associations between CUM score and patients' demographic and clinical characteristics an ordered logit model was fit and interactions between psychiatric disorders and diagnostic groups were tested. The analysis showed that, regardless of the diagnostic group, anxiety and depression independently increase the likelihood of having one point higher muscle tenderness score (OR=1.55, 95% CI: 1.13-2.12 and OR=1.56, 95% CI: 1.10-2.21, respectively). A careful screening for the presence of an underlying psychiatric disorder, either anxiety or depression, should be part of the clinical evaluation in patients suffering from facial pain.

Accompanying symptoms and psychiatric comorbidity in migraine and tension-type headache patients.

OBJECTIVE: Our objective was to assess the prevalence of accompanying symptoms of migraine and tension-type headache in patients with such conditions (both episodic and chronic) and in headache-free controls, and their relationship with depression and anxiety. METHOD: A psychological assessment (Axis I, DSM-IV) was performed, and 21 accompanying symptoms were investigated in 506 patients with episodic migraine (231), chronic migraine (102), episodic tension-type headache (83), and chronic tension-type headache (90) and in 80 controls. The relationship between symptoms, headache type, and psychiatric comorbidity was analyzed. RESULTS: The mean number of symptoms was significantly higher in patients (n=10.3) than in controls (n=3.4). Most symptoms were significantly associated with depression and anxiety, while only some of them were significantly associated with headache, with no relevant difference among groups. CONCLUSION: In headache patients, psychiatric comorbidity (compared with headache type or chronicity) seems to be more strictly associated with an increased burden of accompanying symptoms.

Muscle tenderness in different headache types and its relation to anxiety and depression.

To assess in patients with migraine and tension type headache, both episodic and chronic, the extent to which muscle tenderness may relate to anxiety and depression, 459 patients with Episodic Migraine (EM, 125), Chronic Migraine (CM, 97), Episodic Tension Type Headache (ETTH, 82), Chronic Tension Type Headache (CTTH, 83), and EM+ETTH (72) were enrolled. For each patient, a psychological assessment on the Axis 1 of the DSM-IV and muscle palpation of pericranial and cervical muscles were carried out. A Pericranial Muscle Tenderness Score (PTS) and a Cervical Muscle Tenderness Score (CTS) were calculated (range 0-3). Logistic and linear regression analyses were employed to assess relations between muscle tenderness, the demographic variables and psychiatric disorders in the different patient groups. Odds ratio for 'male gender' was higher in groups with tension type headache. Only EM patients showed a positive association with increasing age. Anxiety and depression were significantly associated to CM. A significant negative correlation of PTS and CTS was observed in EM patients. In relation to male gender, the PTS was significantly lower in EM, ETTH and CTTH; CTS was significantly lower in EM, CM, and CTTH. Anxiety and, even more, anxiety and depression combined were positively associated to higher PTS and CTS in EM patients. Anxiety and depression were also positively associated to higher CTS in patients with EM+ETTH. In CTTH patients, PTS only was positively associated to anxiety and depression. We conclude that in patients with EM, the presence of anxiety or anxiety and depression combined considerably increases the level of muscle tenderness in the head and, even more, in the neck, and might facilitate the evolution into CM.