Is there a correlation between arthroscopic findings and the clinical signs and symptoms of patients with internal derangement of the temporomandibular joint? A prospective study.

The aim of this study was to evaluate the correlation between clinical signs and symptoms of patients with internal derangement of the temporomandibular joint (TMJ) and arthroscopic findings. The study included a sample of 67 patients who underwent TMJ arthroscopy. The variables evaluated were the arthroscopic findings of synovitis, chondromalacia, adhesion, and roofing. The Spearman correlation index was used to correlate these findings with the clinical signs and symptoms of internal derangement of the TMJ, namely maximum mouth opening, pain (visual analogue scale, VAS), and the Wilkes classification. The mean age of the population was 36.16 years, and 85% were female. There was a correlation between pain and synovitis (P=0.0029, r=0.3508), between mouth opening limitation and the amount of adhesion (P=0.0004, r=-0.4084), and between Wilkes classification and the presence of chondromalacia and disc displacement (P=0.001, r=0.374 and P=0.0045, r=-0.3357, respectively). No correlation was found between age and the presence of chondromalacia (P=0.3444, r=0.1147). Patients who had worse pain symptoms had more advanced stages of synovitis, and the increased presence of adhesions was associated with limitations in mouth opening. Furthermore, those with more advanced Wilkes stages had greater disc displacement and more severe stages of chondromalacia.

Motor neuron disease in the province of Ferrara, Italy, in 1964-1982.

We carried out an intensive incidence, prevalence, and mortality survey of motor neuron disease (MND) in the province of Ferrara, northern Italy. Based on 72 patients, the mean incidence per year for the period 1964 through 1982 was 0.98 cases per 100,000. On December 31, 1981, the prevalence rate was 3.95 per 100,000. In the 19-year period the average mortality rate was 0.83 per 100,000 per year. The disease was more common in men, in individuals aged 50 to 70 years, and in residents in rural areas engaged in agricultural work. A retrospective case-control study, confirming a significantly higher frequency of MND in farmers and persons living in rural areas, revealed that the disease was more common in the lower social classes to which most unskilled and heavy laborers belong. In addition, a significantly increased risk for MND was found in patients with previous histories of trauma, but confounding variables may account for this association.

[Value of electromyography for the detection of peripheral neuropathies in the course of chronic hepatopathies]. / Importanza della elettromiografia per il rilievo delle neuropatie periferiche in corso di epatopatie croniche.

It has recently been noted that peripheral nerve fibres are involved in the course of chronic liver disease. The existence of hepatic polyneuropathy is still a matter of debate. A series of 29 subjects (not including diabetics or alcoholics) were examined clinically and electromyographically. Signs of distal lower extremity polyneuritis (paresthesia, hypoesthesia and osteotendinous hypo-areflexia) were noted in 31%. Latent neuropathy was observed in the form of slow maximum and minimum motor conduction rates in clinically unimpaired nerves. Electromyographical alterations were more evident in subjects with frankly chronic as opposed to barely chronic liver disease.

Cryoglobulinemic neuropathy related to hepatitis C virus infection. Clinical, laboratory and neurophysiological study.

Peripheral neuropathy is frequently reported in mixed cryoglobulinemia. As a close relationship has been established between mixed cryoglobulinemia and hepatitis C virus (HCV), the clinical, neurophysiological, and serologic findings of five patients affected by neuropathy, cryoglobulinemia and HCV infection were investigated. HCV infection was ascertained by the presence in the serum of anti-HCV antibodies detected by enzyme-linked immunosorbent assay(ELISA), and of HCV RNA assessed by polymerase chain reaction (PCR). Initial symptoms included paresthesias and painful dysesthesias in the legs. Later on, the patients developed a mainly asymmetric axonal polyneuropathy or a multifocal neuropathy associated with signs of systemic vasculitis. In this case series we report the short-term prognosis, as well as the response to interferon (IFN) alpha and conventional treatment. The presence of HCV RNA supports the hypothesis that a persistent HCV infection might be involved in the pathogenesis of mixed cryoglobulinemia and cryoglobulinemia-associated disorders.

Sleep apneas, convulsive syncopes and autonomic impairment in type I Arnold-Chiari malformation.

A 51-year-old man with type I Arnold-Chiari malformation presented with severe autonomic impairment. Polysomnography disclosed central and obstructive sleep apneas. During REM sleep apneas were accompanied by hypotension and led to convulsive nonepileptic attacks. Marked blood pressure oscillations and central apneas persisted after tracheostomy.