Interactive group therapy for the management of myofascial temporomandibular pain.

Background and aim To evaluate the outcome of a group therapy approach in the management of myofascial temporomandibular pain (TMD) through promotion of self-care.Methods A group based interactive session was introduced for those patients who, at initial consultation, were diagnosed with myalgic TMD. Feedback forms and telephone interviews were used to record patient reported outcome measures to assess patient satisfaction with the service.Results Fifty-five patients attended 17 group sessions over ten months. Feedback revealed a high level of satisfaction immediately after the session with 71% (n = 39) of patients opting for discharge, reporting confidence to self-manage in primary care. This effect appears to be sustainable up to 11 months.Conclusions This approach benefits patients with myofascial TMD through promotion of self-management while utilising health care resources efficiently.

Cine MR Fourier velocimetry of blood flow through cardiac valves: comparison with Doppler echocardiography.

Noninvasive measurement of blood flow velocity through the cardiac valves has important clinical applications. A wide variety of MR methods are available for flow measurement. The aim of this study was to investigate the ability of cine MR Fourier velocimetry to measure flow through healthy cardiac valves and to compare MR and Doppler peak velocity measurements. Ten healthy volunteers (age mean +/- SD, 24 +/- 4 years) without history of valvular disease were studied. Four of the subjects were females. In each subject, aortic, pulmonary, mitral, and tricuspid valves were evaluated with MR and Doppler imaging. A whole-body mobile MR machine was used, operating at .5-T with actively shielded magnetic field gradient coils on all three axes capable of 20 mT/m at a slew rate of 60 mT/ m/msec. The heart rate during MR and Doppler studies was not significantly different. The mean difference between the two studies was 2 beats/min, with a 95% confidence interval of -22 beats/min, +25 beats/ min. Peak systolic flow velocity in the aortic and pulmonary valves and peak diastolic flow velocity in the mitral and tricuspid valves measured with MRI and Doppler echocardiography correlated well. The mean difference between the two measurements (MR-Doppler) was 63 mm/sec, with a 95% confidence interval of -180 mm/sec, +310 mm/sec. The agreement between two observers interpreting the same MR velocity maps was close. The mean difference between their two measurements was 23 mm/sec, with a 95% confidence interval of -20 mm/sec, +60 mm/sec. There was no significant difference between MR and Doppler imaging or between the two MR observers. MR Fourier velocimetry has the necessary ease, reliability, and speed to measure blood flow through the cardiac valves, although measurement of late diastolic flow in the atrioventricular valves is limited. Measurement of peak blood velocity through the cardiac valves by this method showed satisfactory agreement with Doppler, but its clinical application for assessing diseased cardiac valves must be established.