Piroxicam and laser phototherapy in the treatment of TMJ arthralgia: a double-blind randomised controlled trial.

This study aimed to evaluate the efficacy of piroxicam associated with low-level laser therapy compared with single therapies in 32 patients presenting temporomandibular joint arthralgia in a random and double-blind research design. The sample, divided into laser + piroxicam, laser + placebo piroxicam and placebo laser + piroxicam groups, was submitted to the treatment with infrared laser (830 nm, 100 mW, 28 s, 100 J cm(-2) ) at 10 temporomandibular joint and muscle points on each side during four sessions concomitant to take one capsule a day of piroxicam 20 mg during 10 days. The treatment was evaluated throughout four sessions and 30 days follow-up through visual analogue scale (VAS), maximum mouth opening and joint and muscle (temporal and masseter) pain on palpation. The results showed that all the study groups had a significant improvement in the VAS scores (P < 0·05), and there were no significant group differences. Piroxicam was effective in the reduction of joint and muscle pain on palpation (P < 0·05) and showed the lowest temporal pain (P = 0·02) at the 30-day follow-up. The combination of low-level laser therapy and piroxicam was not more effective than single therapies in the treatment of temporomandibular joint arthralgia. The use of piroxicam was more effective in the following 30 days.

Helminths from a stranded manatee in the Dominican Republic.

Endangered West Indian manatees (Trichechus manatus) are known to be parasitized by a number of helminths and ectoparasites. Records of parasitic associations exist for Florida, Mexico, Guyana, Brazil, Cuba and recently for Puerto Rico. Parasites of manatees in other Caribbean areas have not been documented, particularly from Hispaniola. We report on the occurrence of a species of nematode and of two trematodes from a 238-cm male manatee from Portillo (19 degrees 20' N, 69 degrees 35' W), Las Terrenas, in the Dominican Republic. Three species of helminths were collected, including the opisthotrematid Cochleotrema cochleotrema, the ascarid Heterocheilus tunicatus, and the paramphistomid trematode Chiorchis fabaceus. The documentation of these helminths constitutes the first record of these parasites and host relationships for Hispaniola and the second for the northeastern Caribbean.