Efficacy of dry needling in patients with myofascial temporomandibular disorders related to the masseter muscle

ABSTRACT

Objective

This randomized, single-center clinical trial aimed to compare the efficacy of superficial dry needling (SDN) and deep dry needling (DDN) in patients with myofascial temporomandibular disorder (MTMD) related to the masseter muscle.Methods: Forty patients showing MTMD with trigger points in the masseter muscle were randomly assigned to groups. Dry needling of the masseter muscle was performed once per week for three weeks. Pressure pain threshold (PPT) measurements, visual analog scale scores, and maximal jaw opening were assessed.Results: Both patient groups showed significant pain reduction, but the SDN group showed significantly better pain reduction. The PPT measurements obtained in the follow-up examinations at three and six weeks were significantly better than the values in SDN and DDN groups.Discussion: SDN showed better pain-reduction efficacy in patients with MTMD. Further research with a larger size sample and a longer follow-up period will help elucidate the benefits of SDN.     

Effects of short-term transdermal hormone replacement therapy on glycaemic control,lipid metabolism,C-reactive protein and proteinuria in postmenopausal women with type 2 diabetes or hypertension

BACKGROUND: The study was carried out to evaluate the effects of short-term transdermal hormone replacement therapy (HRT) on glycaemic control, lipid metabolism, C-reactive protein (CRP) and proteinuria in high-risk postmenopausal women. METHODS: A total of 20 well-controlled type 2 diabetic, hypertensive and 21 well-controlled glucose-tolerant, hypertensive postmenopausal women were prospectively enrolled. After 12 weeks of transdermal HRT, the changes in serum lipid sub-fractions, fasting glucose, fructosamine, glycated haemoglobin (HbA(1c)), CRP, creatinine, 24 h urine protein levels, creatinine clearance and blood pressure were evaluated. RESULTS: After 12 weeks of treatment, serum total-cholesterol and low-density cholesterols (LDL-cholesterol) appeared slightly reduced and serum triglyceride slightly elevated, although non-significantly so in both groups. The increase in HDL-cholesterol (P < 0.05) and reduction in very low density (VLDL)-cholesterol (P < 0.05) levels were significant in hypertensive patients. Elevation in the Apolipoprotein A1 (P < 0.05) and reduction in the Apolipoprotein B (P < 0.05) levels were statistically significant in all patients. HRT was associated with significant decreases in serum fasting glucose (P < 0.05) and fructosamine (P < 0.05) levels in diabetic patients. Serum HbA(1c), CRP, creatinine, 24 h urine protein levels, creatinine clearance and systolic and diastolic blood pressure did not change significantly in either group. CONCLUSIONS: There were no detrimental effects of transdermal HRT on lipid profile, glucose metabolism, CRP and urine protein levels in our well-controlled diabetic or hypertensive patients. A decision regarding HRT use should be taken on a case-by-case basis.     

Review of stem cells as promising therapy for perianal disease in inflammatory bowel disease

Those patients with perianal Crohn’s disease or ulcerative colitis experience a difficult to treat disease process with a delayed state and often inability to heal despite current therapies. The approaches currently used to treat these patients with corticosteroids, antibiotics, immunomodulators, anti-tumor necrosis factor-α drug, and surgical repair are limited in their healing ability. This review presents all current literature since emergence in the early 2000s of stem cell therapy for patients with perianal inflammatory bowel disease and analyzes the efficacy, outcomes and safety within these studies.     

Effects of intranasal estradiol treatment on serum paraoxonase and lipids in healthy, postmenopausal women

BACKGROUND/AIMS: Serum lipid concentrations worsen after the menopause because of estrogen deficiency, leading to an increased atherogenic pattern. It is known that serum paraoxonase (PON1) activity prevents the development of atherosclerosis. The aim of this cross-sectional study was to observe the effects of intranasal 17beta-estradiol (300 microg/day) on serum PON1 and lipid levels in healthy postmenopausal women. METHODS: 48 healthy, postmenopausal women were enrolled into this cross-sectional study. 28 subjects without an intact uterus and ovaries were using single-dose (300 microg/day) intranasal 17beta-estradiol and 20 subjects with spontaneous natural menopause were not on any hormone therapy. Body mass index (BMI), blood pressure, serum follicle-stimulating hormone, estradiol, fasting glucose, insulin, lipid fractions and PON1 levels were measured. Homeostasis model assessment (HOMA-R) was used to estimate insulin resistance. RESULTS: The higher estradiol, high-density lipoprotein and salt-stimulated paraoxonase (SSP) levels were observed in intranasal 17beta-estradiol users in comparison with non-users. There were no statistically significant differences in BMI, blood pressures, other lipid fractions, basal paraoxonase, arylesterase, fasting glucose and insulin levels, HOMA-R between the groups. SSP was inversely associated with fasting insulin levels and HOMA-R. CONCLUSION: These observations may suggest that intranasal 17beta-estradiol does not have harmful effects on the PON1 activity and lipid metabolism.     

Overexpression of Fc mu receptor (<Emphasis Type="Italic">FCMR</Emphasis>, <Emphasis Type="Italic">TOSO</Emphasis>) gene in chronic lymphocytic leukemia patients

Rai and Binet staging systems that have been used as a standard method for evaluating the prognosis of chronic lymphocytic leukemia (CLL) have some restrictions in distinguishing the early stage CLL patients that will progress rapidly. To solve this shortcoming, prognostic parameters other than staging have become important in the recent years. Intracellular upregulation of Fc mu receptor (FCMR, FAIM3/TOSO) gene in the leukemic lymphocytes of the patients with CLL may be an important parameter in predicting the progression of the disease. In this study, FCMR mRNA expression levels were evaluated in 50 CLL patients and in 50 healthy controls. FCMR mRNA expression was found to be significantly higher in CLL patients than in healthy controls. We, then, evaluated FCMR mRNA levels according to the stages of CLL. Rai stage 0, I, II cases were compared with stage III and IV, and Binet A was compared with Binet B and C according to FCMR mRNA levels. In cases with higher risks, Rai stage III, IV and Binet stage B and C, FCMR mRNA levels were also significantly higher. In addition, overexpression of the FCMR seems to be promoting the chromosomal abnormalities. As a result, we found that the mRNA levels of FCMR in the CLL patients are 23-fold higher than that of the control group and this may suggest that it can be associated with the disease progression and survival. For this reason and because of the simplicity of analyzing with Q-PCR, it can be a useful clinical parameter, after its importance has been shown in larger and multi-variate studies.     

Culprit for recurrent acute gastrointestinal massive bleeding: &ldquo;Small bowel Dieulafoy&rsquo;s lesions&rdquo; - a case report and literature review

A Dieulafoy's lesion is a dilated, aberrant, submucosal vessel that erodes the overlying epithelium without evidence of a primary ulcer or erosion. It can be located anywhere in the gastrointestinal tract. We describe a case of massive gastrointestinal bleeding from Dieulafoy’s lesions in the duodenum. Etiology and precipitating events of a Dieulafoy’s lesion are not well known. Bleeding can range from being self-limited to massive life- threatening. Endoscopic hemostasis can be achieved with a combination of therapeutic modalities. The endoscopic management includes sclerosant injection, heater probe, laser therapy, electrocautery, cyanoacrylate glue, banding, and clipping. Endoscopic tattooing can be helpful to locate the lesion for further endoscopic re-treatment or intraoperative wedge resection. Therapeutic options for re-bleeding lesions comprise of repeated endoscopic hemostasis, angiographic embolization or surgical wedge resection of the lesions. We present a 63-year-old Caucasian male with active bleeding from the two small bowel Dieulafoy’s lesions, which was successfully controlled with epinephrine injection and clip applications.