The objective of this study was to analyze spatial patterns of ground-level ozone concentration in the DALLAS-Fort Worth, Texas metropolitan area. Average daily maximum eight-hour ozone concentration, number of days with concentrations exceeding 75 ppb, average outside air temperature, and resultant wind direction at 20 monitoring stations were compiled for January-December, 2013. Recent estimates of population and vehicle miles traveled were also compiled for 12 counties with ozone monitoring station (s). Ozone levels and resultant wind directions were mapped for representative months in each season. On several days from May-October, eight-hour ozone measurements exceeded 75 ppb. September, followed by August, produced the highest ozone concentrations, as well as the most observations exceeding 75 ppb. Late spring and summer months also showed the greatest range in ozone concentrations; during this time period, sustained southeasterly winds caused distinct clusters of high ozone concentration at the northern perimeter of the study area. However, ozone concentrations at individual monitoring stations were not associated with population or vehicle miles traveled in counties occupied by those stations.

Introduction: Pelvic floor muscles dysfunction is one of the most important etiologies of coccydynia; therefore, manual therapies have been proposed as the first line of treatment. The purpose of this study was to investigate the effect of biofeedback as a new approach in the treatment of coccydynia. Methods: Thirty women were randomized into two groups. Both groups were injected with the corticosteroid. One group received pelvic floor muscle exercises plus biofeedback while the other group only performed exercises. The patient’ s pain was measured using the Visual Analog Scale (VAS) in the first visit and after 1, 2, and 6 months of follow-up as well as DALLAS pain and SF-36 quality of life questionnaires before and 2 months after the treatment Results: Pain had improved significantly after 1, 2, and 6 months in both groups compared to the baseline. However, the amount of change was not different between the groups at any time interval. The results were the same for the DALLAS pain scale and SF-36 quality of life questionnaire. Conclusion: Adding biofeedback to pelvic floor muscle exercises did not lead to any further improvement in the management of chronic coccydynia. Further studies with larger sample sizes may reveal the effect of biofeedback more clearly

Background: Corticosteroid injection is frequently used for chronic coccydynia management. Ultrasonography can be used to improve the accuracy of the injection. This study aims to assess the clinical outcome of ultrasound-guided compared to blind coccygeal injection in chronic coccydynia. Methods: Thirty patients with chronic coccydynia were randomized into two groups and received a coccygeal corticosteroid injection at maximum tenderness point: 15 patients with and 15 patients without ultrasound guidance. The patient’, s pain was evaluated with the visual analog scale (VAS) at 1-, 4-, 8-, and 24-week postinjection. Furthermore, the DALLAS Pain Questionnaire was assessed before injection,also, four and eight weeks after treatment. The quality of life of patients was evaluated before an assessment and four weeks after the intervention by the SF-36 questionnaire. Results: The VAS score decreased significantly 24-week after the intervention in both ultrasound-guided and blinded groups (P <. 001), without any significant difference between the groups (P =. 964). Similarly, the DALLAS pain scale had a significant decrease at eight weeks after intervention in both groups (P <. 001) with no significant difference between the groups (P =. 972). Although there was a significant improvement in the patient’, s quality of life in each group eight weeks after the intervention, it was not significantly different between the two groups. Neither of the treatment groups had any adverse effects associated with the injection. Conclusion: There were no significant differences in the clinical outcome of coccygeal ultrasound-guided vs. blind steroid injection for chronic coccydynia.