Pain threshold values during periodontal probing: assessment of maxillary incisor and molar sites

Probing pain threshold (PPT) assessments were conducted in the facial and oral sulci of maxillary central incisors and first molars of 10 periodontally healthy adults. All subjects were systemically healthy, free of pain, and reported no current medication usage. A computer-linked electronic probe, modified to deliver steadily increasing forces up to 200 grams, was used to collect the data. The system contained a subject operated "off-switch" which, upon activation, signaled the computer to record the subject's PPT. Assessments of each subject's PPTs were conducted on 3 separate occasions at 7-day intervals. Results indicated that the facial sulci of the incisors were the most pain sensitive. They displayed a mean PPT of 50.9 +/- 26.6 grams. The oral sulci of the incisors exhibited a mean PPT of 76.5 +/- 45.2 grams. Facial and oral sulci of the molars evidenced mean PPT values of 102.6 +/- 52.1 grams and 113.5 +/- 51.3 grams, respectively. These data suggest that sulci associated with incisor teeth are nearly twice as pain sensitive as sulci associated with molar teeth. In addition, facial sulci are significantly more pain sensitive than oral sulci. Data did not indicate a visit effect nor a side-of-mouth effect on PPT values.     

Effect of the examiner's race on black children's Wechsler preschool and primary scale of intelligence IQ.

Used a test-retest design to investigate the effect of examiner's race on the IQ scores of 28 male and 14 female low-income black 47-69 mo old preschoolers. 6 female examiners, 3 black and 3 white, administered an abbreviated form of the Wechsler Preschool and Primary Scale of intelligence to the Ss. Each S was tested by a black examiner and by a white examiner. Results indicate that the main effect of the examiner's race was significant for the Verbal, Performance, and Full-Scale IQs. The children earned higher mean scores when tested by the examiner of similar ethnic origin. A significant administration effect and Administration * Sex effect was revealed on the Verbal scale. (37 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tyrosine phosphorylation of focal adhesion kinase (p125FAK): regulation by cAMP and thrombin in mesangial cells

This study aimed at evaluating the influence of submaximal isometric contraction on pressure pain thresholds (PPTs) in 14 fibromyalgia (FM) patients and 14 healthy volunteers, before and after skin hypoesthesia. PPTs were determined with pressure algometry over m. quadriceps femoris before, during and following an isometric contraction. Maximum voluntary contraction (MVC) was assessed using a computerized dynamometer. A contraction of 22% MVC on average was held until exhaustion (max. 5 min) and PPTs were assessed every 30 sec. A local anesthetic cream and a control cream were applied following a double-blind design and PPTs were reassessed. In healthy volunteers PPTs increased during contraction (P < 0.001), then decreased after the end of contraction (P < 0.001) but remained above precontraction values during the 5 min of post-contraction assessments (P < 0.001). In FM patients PPTs decreased in the middle of the contraction period (P < 0.05) and remained below precontraction levels during the rest of the contraction period (P < 0.05) and during the 5 min of post-contraction assessment (immediately post-contraction NS; 2.5 min post-contraction P < 0.01; 5 min post-contraction P < 0.05). The normalized PPTs were significantly lower in patients than in controls during contraction (start P < 0.01; middle P < 0.001; end P < 0.001) and at all times during post-contraction assessments (P < 0.001). Anesthetic cream raised PPTs at rest in controls (P < 0.01) but not in FM patients, and did not influence contraction or post-contraction PPTs in either group. Therefore, the increased pressure pain sensibility in FM patients is more pronounced deep to the skin. The observed decrease of PPTs during isometric contraction in FM patients could be due to sensitization of mechanonociceptors caused by muscle ischemia and/or dysfunction in pain modulation during muscle contraction.     

Notification of purpose in custody evaluation: Informing the parties and their counsel.

The process of alerting child custody and access litigants to the purposes, procedures, and ramifications of the child custody or parenting examination invokes both psychological and legal considerations. A full and complete notification of purpose can be accomplished only by a coordinated effort between the examiner and counsel. In light of the range of potential variations in examiner approach, this notification may be individualized to reflect the examiner's style and the case needs. Because of the abundance of information to be included and the importance of the inclusion of counsel in the process, written notification, provided in advance of the examination, is useful. The basic elements of a notification are discussed, to be adapted to the parameters of the examiner's practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Load pattern and pressure pain threshold in the upper trapezius muscle and psychosocial factors in medical secretaries with and without shoulder/neck disorders

OBJECT: A current hypothesis for the genesis of muscular complaints in the shoulder/neck region postulates that short periods with a completely relaxed muscle are essential to avoid complaints. Another hypothesis is that these disorders are related to psychosocial conditions at work. In order to test these hypotheses, 23 medical secretaries were investigated. METHODS: The load pattern during work in the upper trapezius muscle bilaterally was assessed with electromyographic (EMG) technique and exposure variation analysis (EVA). In addition, pressure pain threshold (PPT) was measured on the trapezius muscle bilaterally and on the sternum. Psychosocial conditions at work were assessed with a questionnaire. RESULTS: The medical secretaries with complaints had significantly fewer episodes with totally or close to totally relaxed muscle compared with the healthy group. The group with complaints tended to have a more monotonous load pattern at low levels (approx. 1%-5% maximum voluntary contraction) while the healthy group had more frequent pauses but also somewhat more frequent short load peaks. The group with complaints showed lower PPT readings compared with the healthy group. However, the whole group had considerably lower PPTs than is usually reported in the literature. Of the 12 questions in the psychosocial questionnaire only one regarding work task satisfaction showed a significant difference between the two groups. CONCLUSION: Support is found for hypothesis that secretaries without complaints have more frequent episodes with totally relaxed muscle. A significant difference is found regarding work task satisfaction.     

Time-related differential effects of epidural morphine on the neuraxis

To clarify the site and potency of the analgesic and anesthetic action of epidurally administered morphine, we investigated the effects of epidurally and intravenously administered morphine (100 micrograms/kg) on change in the pressure pain threshold (PPT) and the minimum alveolar concentration (MAC) of halothane. Epidural morphine (EM) increased PPT significantly (P < 0.01) at the points around the surgical incision by 40% and 60% from baseline compared with intravenous morphine (IM) with which PPT remained at baseline 1 and 2 h after administration, respectively. Duration of analgesia was much longer in EM than in IM (18 h vs 1.7 h). EM increased PPT from preoperative value at the forehead and the points around the surgical incision by 9.9% and -24.9% at 1 h, by 10.9% and 3.8% at 4 h, and by -19.5% and -50.4% at 12 h after administration at mean values, respectively. Halothane MAC in EM and IM were 0.54% and 0.57%, respectively, 40 min after administration. Halothane MAC in EM at 4 h and 12 h after administration were 0.45% and 0.70%, respectively. The results suggest that EM provides long-lasting analgesia by its time-related differential effects on the neuraxis.     

Expectancy bias in trait anxiety.

The ability of anxious and control participants to learn about signals for danger and safety was tested within an autonomic conditioned inhibition (A+/AB-) procedure. Only participants who could verbalize the differential contingencies between the stimuli and shock (aware participants) showed discrimination on electrodermal and shock expectancy measures. In Exp 1, aware high-anxious participants showed similar responding to control participants. However unaware high-anxious participants showed heightened shock expectancy to all stimuli. Exp 2 replicated this expectancy bias in anxious unaware participants controlling for shock intensity. In both experiments, expectancy bias was associated primarily with anxiety rather than depression. Results support the notion of an interpretive bias in anxious participants under ambiguous threat, consistent with recent findings from information-processing research on linguistic stimuli. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sensitivity to Expectancy Violations in Healthy Aging and Mild Cognitive Impairment.

In this study, individuals with mild cognitive impairment (MCI) were tested to see if executive dysfunction impacts their implementation of expectancy biases in a priming task. Young adults, healthy older adults, and individuals with MCI made speed-related decisions to sequentially presented word pairs. The proportion of category related (e.g., apple-fruit) versus coordinate related (apple-pear) pairs was varied to create different expectancy biases. When the proportion of category pairs was high (80%), the control groups showed an expectancy bias: Significant inhibition was observed for coordinate pairs compared with category pairs. The MCI group also demonstrated an expectancy bias but with much larger costs for unexpected targets. The findings suggest that individuals with MCI are inordinately sensitive to expectancy violations, and these findings are discussed in terms of possible executive dysfunction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The reproducibility of cephalic pain pressure thresholds in control subjects and headache patients

Pain pressure thresholds (PPT) were measured at 13 cephalic points bilaterally in 30 headache patients (10 with tension-type headache, 10 with migraine and 10 with cervicogenic headache) and 10 control subjects on three different days. During the sessions, the subjects reported their pain intensity on the right and left sides of the head on a visual analogue scale (VAS). The variability between days was estimated as a coefficient of repeatability (CR = 2 standard deviations of intraindividual differences). The mean CR across all 13 locations was larger in headache patients (2.0 kg/cm2) than in controls (1.68 kg/cm2). Variability (CR) was larger in headache patients as compared to control subjects for 11 of the 13 points (p = 0.02). Reliability was better in controls (intraclass correlation coefficients (ICC) ranging from 0.55 to 0.85) than in headache patients (ICC ranging from 0.43 to 0.78). A moderate negative association between PPT and pain intensity was demonstrated. The intraindividual PPT difference (PPT on the most painful occasions-PPT on the least painful occasions) was negative at 12 of 13 cephalic points (p = 0.003, across-location mean difference: -0.20 kg/cm2). The PPT differed significantly from one day to the next. A part of this variation was presumably related to the circumstances around the procedure; thresholds were lower when the subjects came directly to algometry without any preceding medical examination at all 13 points (p = 0.0002). These results have implications for the planning of future algometer studies. The sample size that is required in studies of headache patients is greater than that in studies of healthy subjects, especially when patients suffer from pain during the PPT session. Particular attention should be paid to circumstances (e.g. preceding medical investigations) around the algometry procedure in order to reduce variability.     

Sensory dysfunction in fibromyalgia patients with implications for pathogenic mechanisms

This study, addressing etiologic and pathogenic aspects of fibromyalgia (FM), aimed at examining whether sensory abnormalities in FM patients are generalized or confined to areas with spontaneous pain. Ten female FM patients and 10 healthy, age-matched females participated. The patients were asked to rate the intensity of ongoing pain using a visual analogue scale (VAS) at the site of maximal pain, the homologous contralateral site and two homologous sites with no or minimal pain. Quantitative sensory testing was performed for assessment of perception thresholds in these four sites. Von Frey filaments were used to test low-threshold mechanoreceptive function. Pressure pain sensitivity was assessed with a pressure algometer and thermal sensitivity with a Thermotest. In addition the stimulus-response curve of pain intensity as a function of graded nociceptive heat stimulation was studied at the site of maximal pain and at the homologous contralateral site. FM patients had increased sensitivity to non-painful warmth (P < 0.01) over painful sites and a tendency to increased sensitivity to non-painful cold (P < 0.06) at all sites compared to controls, but there was no difference between groups regarding tactile perception thresholds. Compared to controls, patients demonstrated increased sensitivity to pressure pain (P < 0.001), cold pain (P < 0.001) and heat pain (P < 0.02) over all tested sites. The stimulus-response curve was parallely shifted to the left of the curve obtained from controls (P < 0.003). Intragroup comparisons showed that patients had increased sensitivity to pressure pain (P < 0.01) and light touch (P < 0.05) in the site of maximal pain compared to the homologous contralateral site. These findings could be explained in terms of sensitization of primary afferent pathways or as a dysfunction of endogenous systems modulating afferent activity. However, the generalized increase in sensitivity found in FM patients was unrelated to spontaneous pain and thus most likely due to a central nervous system (CNS) dysfunction. The additional hyperphenomena related to spontaneous pain are probably dependent on disinhibition/facilitation of nociceptive afferent input from normal (or ischemic) muscles.     

Streamflow Properties from Time Series of Surface Velocity and Stage

Time series of surface velocity and stage have been collected simultaneously. Surface velocity was measured using an array of newly developed continuous-wave microwave sensors. Stage was obtained from the standard U.S. Geological Survey (USGS) measurements. The depth of the river was measured several times during our experiments using sounding weights. The data clearly showed that the point of zero flow was not the bottom at the measurement site, indicating that a downstream control exists. Fathometer measurements confirmed this finding. A model of the surface velocity expected at a site having a downstream control was developed. The model showed that the standard form for the friction velocity does not apply to sites where a downstream control exists. This model fit our measured surface velocity versus stage plots very well with reasonable values of the parameters. Discharges computed using the surface velocities and measured depths matched the USGS rating curve for the site. Values of depth-weighted mean velocities derived from our data did not agree with those expected from Manning’s equation due to the downstream control. These results suggest that if real-time surface velocities were available at a gauging station, unstable stream beds could be monitored.     

Digital palpation of intraocular pressure

BACKGROUND AND OBJECTIVE: Previous studies investigating the accuracy of digital palpation through the eyelids to estimate intraocular pressure (IOP) have shown disappointing results. In this study, the accuracy of digital assessment of IOP by palpation of the bare cornea is investigated. MATERIALS AND METHODS: The IOP of a cadaveric eye model was varied from 5 to 40 mm Hg in increments of 5 mm Hg. Two examiners, one experienced and one inexperienced, digitally palpated the corneas and estimated IOP. The results were compared before and after a 1-hour training session. RESULTS: Prior to the training session, the experienced examiner guessed correctly 46% of the time and was correct within 5 mm Hg 100% of the time. The inexperienced examiner guessed correctly 21% of the time and was within 5 mm Hg 62% of the time. After the training session, the experienced examiner's score did not significantly (38% correct, 88% within 5 mm Hg, P = .05. CONCLUSIONS: Digital assessment of IOP by palpation of bare cornea is accurate when performed by experienced individuals. A minimal amount of training using the eye model may improve one's accuracy.     

The size of acoustic neuromas: CT and MRI

The growth rate of acoustic neuromas is very variable: some tumours grow rapidly, some do not grow and some even get smaller. When making treatment decisions, it may be important to have an idea of the growth rate of the individual tumour, and this is only possible when there are comparable examinations. We performed both CT and MRI on 15 patients. Two radiologists estimated the size of their acoustic neuromas. There was a significant difference between the two examiners' calculations of tumour volumes on CT and between the first examiner's CT and MRI volume calculations. No difference was found between the two MRI volume estimations or the second examiner's estimation of volumes on CT and MRI. Measurements of the maximal tumour diameter along the pyramid showed good concordance. We conclude that measurement the size of acoustic neuromas is reproducible with MRI and the measurement of the maximal tumour diameter is in practice a better parameter for comparison than calculation of real volume.     

Effect of fetal movement on the amniotic fluid index in diamniotic twin gestations

Fetal movement changes the size and location of amniotic fluid pockets during measurement of the amniotic fluid index. In singleton gestations, the effect of redistributing the fixed intrauterine fluid volume on the amniotic fluid index is clinically insignificant. In this study, we tested the hypothesis that the index in twin pregnancies is unaffected by fetal movement. A single examiner prospectively determined the amniotic fluid index before and after three discrete episodes of movement by both fetuses of 82 diamniotic twin pregnancies referred for obstetric sonograms between 20 and 38 weeks' menstrual age. A reliable blinded examiner provided a second post-movement measurement as a control. Data were analyzed by the paired t-test. The mean change in the amniotic fluid index after fetal movement was 2.1 +/- 0.2 cm and 3.7 +/- 0.3 cm for post-movement determinations by the same and blinded examiners, respectively (p < .001). Interobserver variation was 3.5 cm. Intraobserver variation was 1.8 cm for the first examiner and 2.2 cm for the second examiner. Therefore, interobserver and intraobserver variation can account for the observed change in the amniotic fluid index following movement of both diamniotic twins.     

The human skeletal muscle adenine nucleotide translocator gene maps to chromosome 4q35 in the region of the facioscapulohumeral muscular dystrophy locus

The large number of sequenced clones of HIV-1 and related viruses made it possible to indicate conserved elements with potential regulatory or structural functions. Such analysis was combined with directed mutagenesis in order to investigate the importance of elements that may influence the initiation of plus-strand DNA synthesis. The main site for plus-strand initiation is a polypurine tract near the 3' end of the viral RNA (the 3' PPT). An exact copy of this PPT is located in the middle of the genome (the internal PPT). Upstream from the internal PPT there is an inverted repeat. Mutants designed to upset the internal PPT (i.e., purine to pyrimidine changes), as well as mutants designed to abolish the potential stem-loop formation (changes around the internal PPT or in the upstream inverted repeat) both resulted in viruses with a reduced ability to replicate. Upsetting the stem-loop formation was, however, less harmful than changing the polypurine nature of the PPT. Changing a conserved T on the 3' side of the PPT to a C did not affect the phenotype.     

A validation study of polygraph examiner judgments.

Validated the lie detection judgments in criminal investigations conducted by the military services against unanimous guilt-innocence decisions by a panel of 4 Judge Advocate General (JAG) attorneys. Since the study did not permit isolation of the role played by the polygraph record itself, the examiner's judgment was considered the end product of his complete interrogation of a suspect. Each JAG attorney made an independent decision based upon perusal of case files from which all polygraph references were deleted. Attorneys were instructed to eliminate files lacking sufficient evidence and to disregard legal technicalities. Level of agreement was 92.4%. Percentage of agreement decreased significantly to 74.6% when the criterion was a majority JAG panel decision. The study supports the use by the military services of polygraph examiner judgments as an aid in determining whether to continue or to terminate the investigation of a suspect. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An expectancy model of laboratory preparedness effects.

Experiments investigating differential unconditioned stimulus/stimuli (UCS) expectancy during fear-relevant (prepared) and fear-irrelevant (unprepared) stimuli revealed that (1) a UCS expectancy bias is apparent before conditioning, (2) initial differential UCS expectancy appears in spite of instructions informing the Ss of no UCS presentations, (3) differential UCS expectancies to fear-relevant and fear-irrelevant stimuli dissipate with continued nonreinforcement, (4) differential UCS expectancies may be translated into differential skin conductance responses (SCRs) under certain conditions, (5) both UCS expectancy and SCR measures show similar patterns of behavior in the traditional preparedness paradigm, and (6) experiencing conditioned stimulus/stimuli (CS)–UCS pairings appears to reinstate a UCS expectancy bias after it has extinguished. These results are discussed as support for an expectancy model of laboratory preparedness effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive mediators in the reduction of pain: The role of expectancy, strategy use, and self-presentation.

Eighty subjects underwent three trials of cold-pressor pain. The first cold-pressor trial served as a baseline. Next, subjects in a neutral (no expectancy information) condition were taught a distraction strategy (shadowing letters) before one cold-pressor trial and an imagery strategy before the other. Subjects in other conditions received positive expectancy information about one of the strategies and negative expectancy information about the other. Negative information reduced expectancy ratings and decreased the magnitude of reported pain reductions. Both pretested levels of social desirability and degree of absorption in strategy use made contributions to the prediction of pain reduction that were independent of expectancy ratings. Theoretical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fatal erroneous diagnostic interpretation of the significance of mesenchymal soft-part tumors]

It has often been stated that static retinoscopy findings are not affected by the examiner's refractive correction. To what extent this statement remains true is the subject of this statement remains true is the subject of this paper. The basic principle of retinoscopy is the Foucault test. In this test, a knife edge placed on the principal axis of an optical system (S) intercepts a bundle of rays coming out of (S). Depending on the position of the knife edge, various distributions of light and shadow can be observed on the anterior surface of (S). In retinoscopy it is either the entrance pupil of the examiner or the peephole of the instrument that plays the role of the knife edge. Therefore, any change in conditions that bring about a change in the "knife-edge-pupil" position will result in errors in static retinoscopy. Nevertheless, calculations show that these errors do not become significant under usual clinical conditions of static retinoscopy.