Francis M. Bush

A comparison of pain measurement characteristics of mechanical visual analogue and simple numerical rating scales.

&NA; Numerical rating scales and mechanical visual analogue scales (M‐VAS) were compared for their capacity to provide ratio scale measures of experimental pain. Separate estimates of experimental pain sensation intensity and pain unpleasantness were obtained by each method, as were estimates of clinical pain. Orofacial pain patients made numerical scale and VAS ratings in response to noxious thermal stimuli (45–51°C) applied for 5 sec to the forearm by a contact thermode. The derived stimulus‐response function was well fit as a power function only in the case of sensory M‐VAS. The power function derived from sensory M‐VAS ratings predicted temperatures chosen as twice as intense as standard temperatures of 47°C and 48°C, thereby providing evidence for ratio scale characteristics of M‐VAS. The stimulus‐response function derived from sensory numerical ratings differed from that obtained with M‐VAS and did not provide accurate predictions of temperatures perceived as twice intense as 47°C or 48°C. Both M‐VAS and numerical rating scales produced reliably different stimulus response functions for pain sensation intensity as compared to pain unpleasantness and both provided consistent measures of experimental and clinical pain intensity. Finally, both mechanical and pencil‐and‐paper VAS produced very similiar stimulus‐response functions. The ratio scale properties of M‐VAS combined with its ease of administration and scoring in clinical settings offer the possibility of a simple yet powerful pain measurement technology in both research and health care settings.

Tinnitus and otalgia in temporomandibular disorders

A heterogeneous group of 105 TM patients were questioned about tinnitus and otalgia at an initial visit and again at a final visit 32 months later. Analysis of data showed no statistically positive correlation between the two symptoms although most patients had difficulty in separating onset of both symptoms. Tinnitus was more common within 1 to 5 years after onset than 10 to 15 years after onset. Tinnitus appeared to be an individual problem and was neither group- nor gender-related. Few patients identified an etiology for tinnitus. The use of oral appliances seemed to reduce or eliminate symptoms and the number of patients with fluctuating tinnitus decreased by one half between visits. No change occurred for patients with severe tinnitus.

Malocclusion, Masticatory Muscle, and Temporomandibular Joint Tenderness

The Angle classification of occlusion, as well as occlusal contacts determined at retrusion, mediotrusion, laterotrusion, and protrusion were recorded from 298 dental students. Various masticatory muscles and the TM joints were palpated simultaneously for tenderness. No significant relationships were observed between (1) tenderness and Angle class or (2) tenderness and any occlusal contact. In relation to a slide between retruded contact position and intercuspal position: measurements for (a) vertical and (b) horizontal displacements, but not (c) lateral deflection, were greater in Class I students without tenderness than in Class I students with tenderness.

Use of a habit reversal treatment for temporomandibular pain in a minimal therapist contact format

Previous research has suggested that a habit reversal treatment might be used effectively in a home-based minimal therapist contact (MTC) protocol to facilitate flexibility and increase treatment completion rates. Recent reviews of MTC interventions have found it to be generally efficacious, cost-effective, and generalizable. While MTC has been used for certain health-related disorders (e.g., headache), almost no research has evaluated the effectiveness of a MTC protocol with a population suffering from temporomandibular disorder (TMD). The current study utilized an oral habit reversal treatment in a MTC format in an attempt to reduce attrition and increase treatment flexibility. Twenty females suffering from TMD were randomly assigned to either a treatment (n = 10) or a wait-list control (n = 10) condition. Six individuals in each group used telephone contact while 4 used e-mail for weekly communication with the therapist. Results demonstrated that a habit reversal treatment in a MTC format led to statistically and clinically significant improvements in mean weekly pain ratings, number of pain-free days per week, and highest weekly pain ratings. Also, a significant reduction in maladaptive oral habits occurred from pre- to post-treatment and significant reductions in life stress and pain interference were observed. Results were maintained at follow-up. The implications for the use of MTC for treatment of facial pain are discussed, as are the implications of these findings for the role of oral habits in the etiology of TMD.

Developmental and populational variation in electrophoretic properties of dehydrogenases, hydrolases and other blood proteins of the house sparrow, Passer domesticus.

Abstract 1. 1. Starch gel electropherograms show the specificity of some blood proteins of an altricial species, Passer domesticus. Lipoprotein and eight enzymes separate from plasma; one of these enzymes also separates from red cells. Six of the eight enzymes are described initially from the blood of a Passeriform species; one enzyme of plasma, initially from birds. 2. 2. The yellow-colored plasma of adults separates into more total protein bands than that of hatchling. Fledglings have patterns similar to those of adults. Patterns of nonspecific esterases of hatchlings have fewer bands than those of adults, but diffusion occurs between some bands. Like other birds, activity of alkaline phosphatase is greater in hatchling than in adult plasmas. Bands of amine oxidase exhibit greater activity in 12–14 day posthatchlings than in adults. There are two red cell LDH bands in adults, but only one is well differentiated in embryos and newly hatched young. Other enzyme patterns differ less during differentiation; those of adults generally stain more intesenly. 3. 3. Nonspecific esterases exhibit the most variation in adult populations, then cholinesterase and plasma lactate dehydrogenase. The esterases, naphtylamidase and LDH are easiest to localize. Use of more than one buffer, substrate or dye coupler improves the chance of localizing some enzymes or certain bands with weak activities.

Electron-microscopic study of the rat masseter muscle following injection of lidocaine

The ultrastructure of rat masseter muscle was examined at 15 min, 1 and 6 h, and 1 and 2 days following a single injection of 2% lidocaine. Lesions developed within 15 min. The plasma membrane was disrupted and invaginated. The nuclei were pyknotic and the mitochondria appeared swollen. The myofibrils separated and became disoriented. By 1 and 6 h, these changes were severe. By 1 day, the macrophages appeared in damaged myofibers. The presence of a few presumptive myoblasts signaled the onset of regeneration. By 2 days, presumptive myoblasts formed within the basement membrane. The basal lamina proved most resistant to injury. Regeneration of masseter muscle following the damage produced by lidocaine appeared discontinuous in nature. The singly nucleated presumptive myoblasts seemed to arise within the lesions.

Degenerative Changes in Masseter Muscle Following Injection of Lidocaine : A Histoehemical Study

Changes in suceinic dehydrogenase, adenosine triphosphatase, and phosphorylase activities occurred in masseter muscle by 15 minutes following injeetion of 2% lidocaine. Abolishment of phosphorylase activity suggested an effect on the sarcoplasmic retieulum. Increased staining for succinic dehydrogenase and adenosine triphosphatase activities suggested damage to mitochondria and myofibrils, respectively. Leucine aminopeptidase and glucose-6-phosphate dehydrogenase activities appeared in macrophages.

Otalgia and Aversive Symptoms in Temporomandibular Disorders

The term Costens syndrome has been used in the dentomedical literature to describe a constellation of craniofacial symptoms. Since some of the same complaints have been reported in patients with “generalized” psychological distress, symptoms associated with the syndrome may not be useful in differential diagnosis of temporomandibular disorders. The present study investigated whether some somatic complaints, particularly tinnitus and dizziness, were pathognomonic in patients with chronic temporomandibular pain. Illness behavior and personality factors were studied for possible interrelationships with these symptoms. Factor analysis revealed that tinnitus and dizziness loaded on separate factors. Tinnitus loaded with nasal stuffiness, tearing, and itching of the eyelids and nose, while dizziness loaded with complaints of altered taste and smell and blurred vision. Neither was consistently related to measures of pain or to indices of illness behavior or somatic focus.

The Relationship of TMJ Clicking to Palpable Facial Pain

AbstractA survey of 324 dental students (56 females and 268 males) showed that approximately one-third had clicking in one or both temporomandibular joints. More students had clicking in both joints than in one (56% versus 45%).Gradation of clicking during jaw opening revealed that 30% occurred at early to middle phases and 45% at complete mouth opening. Slight repetitive clicking occurred in 17% of the students and multiple clicking in 9%.Tenderness to palpation was found in the masticatory muscles of 12% of the students. Palpable pain of the external auditory meatus occurred in approximately 1% and joint tenderness upon lateral palpation in nearly 3%.Chi-square testing showed that there was a statistically significant relationship between clicking and palpable pain of the masticatory muscles in those students with these signs and symptoms.

Avian hepatic esterases, pesticides and diet.

Abstract 1. 1. Manometric assays of liver esterase activity in fifty-five species of birds disclosed homogeneous levels in four orders and heterogeneous levels in two, as well as different rates of hydrolysis of different substrates within species. 2. 2. Some correlations were detected between the size or diet of a species and the level of its hepatic esterase activity on phenyl acetate, triacetin and choline esters. 3. 3. Correlations were detected between the diet and the amount of hepatic esterase inhibition on triacetin by parathion, carbaryl and dichlorvos.