Myofascial pain, widespread pressure hypersensitivity, and hyperalgesia in the face, neck, and shoulder regions, in survivors of head and neck cancer.

PURPOSE: Medical treatment for head and neck cancer may induce the presence of inflammation, pain, and dysfunction. The purpose of the current study was to assess the presence of myofascial trigger points (TrPs) and their relationship with widespread pressure hypersensitivity and hyperalgesia in survivors of head and neck cancer (sHNC). METHODS: TrPs and pressure-pain thresholds (PPTs) were quantified in different muscles/joints in the head and neck of 30 sHNC (59.45 ± 13.13 years) and 28 age- and sex-matched controls (58.11 ± 12.67 years). RESULTS: The sHNC had more TrPs in all muscles on the affected side (p < 0.05) than did the healthy controls, and in the temporalis, masseter, and suboccipitalis muscles on the unaffected side (p < 0.05). They also had lower PPTs in all places (p < 0.05) except for the temporalis muscle (p = 0.114) and C5-C6 joint (p = 0.977). The intensity of cervical pain correlated positively with the presence of upper trapezius TrPs. CONCLUSIONS: sHNC suffering cervical and/or temporomandibular joint pain have multiple active TrPs and experience widespread pressure hypersensitivity and hyperalgesia, suggestive of peripheral and central sensitization.

Effect of different feeding strategies in intensive dairy farming systems on milk fatty acid profiles, and implications on feeding costs in Italy.

The aim of this work was to characterize the fatty acid (FA) profile of milk from intensive dairy farming systems in the Po Plain (Italy) to estimate the costs of the adopted feeding strategies and to simulate the effect of supplementary premiums on the basis of milk FA composition on milk income. Twenty dairy farms with 5 different feeding strategies were studied: 3 corn silage-based systems in which cows were supplemented with a great proportion (CCH), a medium proportion (CCM), or without commercial concentrate mix (CC0), and 2 systems in which part of corn silage was replaced with grass or legume silage (HF) or with fresh herbage (G), cut and fed indoors. Bulk milk was sampled and lactating cow performance, feeding strategies and forage characteristics were recorded through a survey, 3 times during a year. The milk FA supplementary premium was calculated considering C18:3n-3 and saturated FA (SFA) concentrations, and ratio of total cis C18:1 isomers to C16:0. The CCH, CCM, and CC0 systems bought most of their dairy cow feeds off farm, which allowed them to increase milk production to 35,000 L/yr per hectare. Their low dry matter and crude protein self-sufficiency led to higher feeding costs per liter of milk (from €0.158 to €0.184), and highest income over feed cost was achieved only for milk yield performance greater than 10,000 kg/cow per year. The use of homegrown forages in HF and G increased dry matter and crude protein self-sufficiency and reduced the feeding costs per liter of milk from 9 to 22%, compared with the other studied systems, making HF and G feeding economically competitive, even for a lower milk yield per cow. The studied systems highlighted a remarkable variation in FA profiles. The concentrations of C16:0 and SFA were the highest in CCH (31.53 and 67.84 g/100g of FA) and G (31.23 and 68.45 g/100g of FA), because of the larger proportion of commercial concentrate mix in the cow diet. The concentrations of C16:0 and SFA were the lowest in CCM (27.86 and 63.10 g/100g of FA), because of low roughage-to-concentrate ratio in the cow diet, which is known to favor milk fat depression, affecting particularly these FA. The calculated supplementary premium was the highest in the CCM system, based on milk FA profiles from those herds. The HF diet was rich in forages and resulted in greater concentration of C18:3n-3 in milk (0.57 g/100g of FA) than the other systems and thus led to an increase in milk FA supplementary premium. Milk from G and HF milk had the lowest ratio of Σn-6:Σn-3 FA compared with milk from the systems based on higher corn silage proportion in the cow diet (3.71, and 3.25, respectively, vs. 4.58 to 4.78), with the lower ratios being closer to recommendation for human nutrition.

Pyrimidine 5'-nucleotidase and oxidative damage in red blood cells transfused to beta-thalassemic children.

Pyrimidine 5' nucleotidase (P5'N) acquired deficiency has been found in several hematologic disorders including beta-thalassemia. Our previous studies suggested that the aldehydes produced during membrane lipid peroxidation could play a role in P5'N inactivation in thalassemia. To evaluate the effects of the thalassemic "environment" on transfused red blood cells, we tested P5'N, pyruvate kinase (PK), glucose 6-phosphate dehydrogenase (G-6PD) activity, creatine content, reduced glutathione (GSH) levels and the hexose monophosphate shunt (HMS) in the red cells of homozygous transfusion-dependent thalassemic children, immediately following and again one month after transfusion. In red cells aged in thalassemic plasma, P5'N activity, creatine level, GSH stability and stimulated HMS flux were significantly decreased. These results fit in with the presence in thalassemic plasma of molecules interfering with antioxidant red cell defenses. Normal red cells incubated in thalassemic plasma display a significant stimulation of the basal HMS (p less than 0.01). Transfused red cell metabolic alterations could be explained by the plasma pro-oxidant activity and may contribute to reducing red cell survival in the host plasma.

Inhibition of hexose monophosphate shunt in young erythrocytes by pyrimidine nucleotides in hereditary pyrimidine 5' nucleotidase deficiency.

Recent reports have suggested that haemolytic anaemia in pyrimidine 5' nucleotidase (P5'N) deficiency might be due to impaired erythrocyte hexose monophosphate shunt (HMS). To investigate the relationship between pyrimidine accumulation, HMS impairment and shortened red-cell survival, we tested glucose 6-phosphate dehydrogenase (G-6PD), HMS, P5'N activities and the UV spectrum in whole red cells and in red cells of different age from 2 P5'N-deficient patients with different degrees of haemolytic anaemia. In whole red cells we found a reduction of both G-6PD and stimulated HMS activity in the presence of a variable amount of pyrimidine nucleotides (37.79 and 17.88 mumol/gHb respectively). A drastic inhibition of stimulated HMS activity was already present in the lightest red-cell fractions from patient 1, who presented a more severe haemolytic anaemia. The variable degree of pyrimidines found among red cell fractions, with a minor accumulation in the older red cells, supports the hypothesis that pyrimidine accumulation and HMS impairment occur in the younger erythrocytes of P5'N-deficient patients.