Symptoms and pathophysiology of cluster headache. Approach to combined occipital and supraorbital neurostimulation.

Cluster headache (CH) is included under section 3 - Trigeminal autonomic cephalalgias (TAC) of the International Headache Society (IHS) classification. It is one of the most frequent, painful and disabling primary headaches. Acute and preventive pharmacological treatments are often poorly tolerated and of limited effectiveness. Due to improved understanding of the pathophysiology of CH, neuromodulation devices are now considered safe and effective options for preventive and acute treatment of CH. In this paper, we review the information available to date, and present the case of a patient with disabling cluster headache highly resistant to medical treatment who underwent implantation of a peripheral nerve neurostimulation system to stimulate the supraorbital nerves (SON) and greater occipital nerve (GON) in our Pain Unit. We also review the diagnostic criteria for CH, the state of the knowledge on the pathophysiology of CH, and the role played by neuromodulation in treating this condition.

Clínica y fisiopatología de la cefalea en racimos. Acercamiento a la indicación de neuroestimulación combinada occipital y supraorbitaria / Symptoms and pathophysiology of cluster headache. Approach to combined occipital and supraorbital neurostimulation

La cefalea en racimos (CR) se encuadra dentro del apartado 3 de la clasificación de la Sociedad Internacional de Cefaleas (IHS), que es el reservado para las llamadas cefaleas trigémino autonómicas (CTA). Se trata de uno de los procesos de cefalea primaria más frecuentes, dolorosos e incapacitantes. Los tratamientos farmacológicos agudos y preventivos son, en muchos casos, mal tolerados y de efectividad limitada. Debido a la mejora en la comprensión de su fisiopatología de la CR, los dispositivos de neuromodulación se han posicionado como opciones seguras y eficaces de tratamiento preventivo y el tratamiento agudo de la CR. Haremos un recorrido sobre la información disponible hasta el momento y además, exponemos el caso de un paciente con CR incapacitante, muy resistente al tratamiento médico, tratado en nuestra Unidad del Dolor con el implante de un sistema de neuroestimulación de nervio periférico de nervios supraorbitario (SON) y nervio occipital mayor (GON). A continuación revisaremos los criterios diagnósticos que la definen la CR, lo datos que conocemos, a día de hoy, sobre su fisiopatología y la posición que ocupa actualmente la neuromodulación en el abordaje terapéutico de la misma. Con la descripción del caso clínico de un paciente tratado en nuestra Unidad del Dolor con una cefalea especialmente severa y resistente al tratamiento farmacológico.(AU)

Cluster headache (CH) is included under section 3 - Trigeminal autonomic cephalalgias (TAC) of the International Headache Society (IHS) classification. It is one of the most frequent, painful and disabling primary headaches. Acute and preventive pharmacological treatments are often poorly tolerated and of limited effectiveness. Due to improved understanding of the pathophysiology of CH, neuromodulation devices are now considered safe and effective options for preventive and acute treatment of CH. In this paper, we review the information available to date, and present the case of a patient with disabling cluster headache highly resistant to medical treatment who underwent implantation of a peripheral nerve neurostimulation system to stimulate the supraorbital nerves (SON) and greater occipital nerve (GON) in our Pain Unit. We also review the diagnostic criteria for CH, the state of the knowledge on the pathophysiology of CH, and the role played by neuromodulation in treating this condition.(AU)

Evaluation of Terpenes' Degradation Rates by Rumen Fluid of Adapted and Non-adapted Animals.

The aim of the present study was to evaluate terpenes degradation rate in the rumen fluid from adapted and non-adapted animals. Four castrated healthy animals, two rams and two bucks, were used. Animals were daily orally dosed for 2 weeks with 1 g of each of the following terpenes, α-pinene, limonene and ß-caryophyllene. At the end of each week, rumen fluid (RF) samples were assayed in vitro for their potential to degrade terpenes over time. For each animal, a 10 mL reaction medium (RM) at a ratio 1:9 (v/v) was prepared and a terpenes solution at a concentration of 100 µg/ml each, was added in each RM tube. Tubes were incubated at 39 °C under anaerobic conditions and their contents sampled at 0, 2, 4, 8, 21 and 24 h. RF could degrade terpenes as it was shown by the significantly (P < 0.05) higher overall degradation rates. Individual terpene degradation rates, were significantly (P < 0.05) higher in week 5 for limonene and marginally (P = 0.083) higher also in week 5 for α-pinene. In conclusion, the findings of the present preliminary study suggest that terpenes can be degraded in the rumen fluid.

Tissue distribution of rare earth elements in wild, commercial and backyard rabbits.

Rare Earth Elements (REEs), La, Ce, Pr, Nd, Sm, Eu, Gd, Tb, Dy, Ho, Er, Tm, Yb, Lu, Sc, and Y, & two actinides, Th and U were assessed in muscle and liver tissues of wild, backyard and commercially raised rabbits through ICP-MS. Higher concentrations were found in liver in comparison to muscle tissue. Liver of wild rabbits accumulates all studied elements beyond Tm. Backyard rabbits do not show any statistically significant accumulation while commercial accumulate all beyond La, Ce, Pr, Nd, Gd and Tb. Wild rabbits were with the highest amounts for most of these elements. The different living and rearing environments of wild, backyard and commercial rabbits may affect accumulation, fate and transfer of REEs in rabbits' tissues. A dataset for establishing reference values of REEs in Lemnos island wild rabbits' is shown and the literature gap on safety limits for REEs is discussed.

Game meat authentication through rare earth elements fingerprinting.

Accurate labelling of meat (e.g. wild versus farmed, geographical and genetic origin, organic versus conventional, processing treatment) is important to inform the consumers about the products they buy. Meat and meat products declared as game have higher commercial value making them target to fraudulent labelling practices and replacement with non-game meat. We have developed and validated a new method for authentication of wild rabbit meat using elemental metabolomics approach. Elemental analysis was performed using rapid ultra-trace multi-element measurement by inductively coupled plasma mass spectrometry (ICP-MS). Elemental signatures showed excellent ability to discriminate the wild rabbit from non-wild rabbit meat. Our results demonstrate the usefulness of metabolic markers -rare earth signatures, as well as other trace element signatures for game meat authentication.

Seasonal variations in the fatty acid composition of Greek wild rabbit meat.

The fatty acid (FA) profile of the Longissimus thoracis et lumborum muscle (LL) was used to investigate seasonal variation (September, November and March) in wild rabbits from Lemnos Island (Greece). The n-3 FA were particularly high during early March in comparison (P<0.05) with late September and late November. Thrombogenicity index (TI) values were lower in March (P<0.05) compared to the other periods. High concentrations of odd- and branched-chain FA were found in the meat of wild rabbits; however, they were not different among the considered periods of the year. The present results showed that wild rabbit meat has a desirable FA profile, particularly during early spring, and it could be a good source of bioactive FA in human nutrition.

Transfer of orally administered terpenes in goat milk and cheese.

The objective of the present study was to investigate the relationships between terpenes' intake and their presence in animal tissues (blood and milk) as well as in the final product (cheese). Eight dairy goats were divided in two balanced groups, representing control (C) and treatment (T) group. In T group oral administration of a mixture of terpenes (α-pinene, limonene and ß-caryophyllene) was applied over a period of 18 d. Cheese was produced, from C and T groups separately, on three time points, twice during the period of terpenes' oral administration and once after the end of experiment. Terpenes were identified in blood by extraction using petroleum ether and in milk and cheese by the use of solid phase micro-extraction (SPME) method, followed by GC-MS analysis. Chemical properties of the milk and the produced cheeses were analyzed and found not differing between the two groups. Limonene and α-pinene were found in all blood and milk samples of the T group after a lag-phase of 3 d, while ß-caryophyllene was determined only in few milk samples. Moreover, none of the terpenes were traced in blood and milk of C animals. In cheese, terpenes' concentrations presented a more complicated pattern implying that terpenes may not be reliable feed tracers. We concluded that monoterpenes can be regarded as potential feed tracers for authentification of goat milk, but further research is required on factors affecting their transfer.

Terpenes transfer to milk and cheese after oral administration to sheep fed indoors.

Terpenes have been proposed as potential biomarkers in verifying the diets of grazing animals. A study of the relationships between the intake of terpenes and their presence in animal tissues (blood and milk) as well as in the final product (cheese) was conducted. Eight dairy sheep were divided into two equal groups, representing control (C) and treatment group (T). In T group oral administration of a mixture of terpenes, α-pinene, limonene and ß-caryophyllene, was applied over a period of 18 days. Blood and milk samples were collected regularly and terpenes were identified by extraction using petroleum ether and the solid phase micro-extraction (SPME) method, respectively, followed by GC-MS analysis. Cheese was produced, from C and T animals separately, twice during the period of terpenes oral administration. Terpenes contents and chemical properties of the produced cheeses were investigated. Limonene and α-pinene were found in all blood and milk samples of the T group after a lag-phase of 2 days, while ß-caryophyllene was detected in few plasma samples and in all milk samples. None of the terpenes was traced in blood and milk of C animals. The contents of cheese, in dosed terpenes, presented a more complicated pattern suggesting terpenes non-credible as biomarkers. We conclude terpenes can be used as biomarkers for authentification of ewes' milk, but further research is required on factors affecting their transfer to dairy products from grazing diets.

The nutritive value of mulberry leaves (Morus alba) as a feed supplement for sheep.

A study to determine the nutritive value of mulberry (Morus alba) leaves in sheep diets was conducted. Mulberry leaves contained (g kg(-1) on dry matter basis): 163 ash, 201 crude protein, 120 crude fibre, 37 ether extracts, 479 nitrogen-free extracts, 268 neutral detergent fibre, 148 acid detergent fibre, 41 acid detergent lignin, 121 cellulose and 107 hemicellulose, while the in vitro true digestibility of dry matter was 89.8%. The nitrogen (N) solubility, determined using: a) McDougall's buffer, b) 0.02 N sodium hydroxide (NaOH) and c) 0.15 N sodium chloride (NaCl) as solvents, ranged from 11.6 to 14.9% of total N. In addition, the soluble non-protein nitrogen contributed a substantial part of total N (26.1%), the total true protein was 14.4% and the protein fractions evaluated after classical protein fractionation, were: albumins 11.1, globulins 9.7, prolamins 44.1, glutelins 8.5 and insoluble (or structural) proteins 26.6% of total N. In a digestibility trial, where mulberry leaves partially replaced lucerne hay and concentrates in wether sheep diets, there were no significant differences in dry matter, crude protein or crude fibre digestibility of the total diet. It was concluded that mulberry leaves have an appreciable potential as a protein source in sheep feeding.

Supporting the extensive dairy sheep smallholders of the semi-arid region of Crete through technical intervention.

The objective of this field study was to depict the extensive system of dairy sheep farming in the semi-arid environment of the island of Crete and to assess the potential margins of improvement through technical intervention. Forty-three family-run farms keeping a total of 13,870 sheep were surveyed in seven representative areas of the island. Several parameters were dealt with, concerning socio-economy, flock management and productivity. Study areas differed widely regarding feeds supplied per sheep, land cultivated for feeds, grazing land utilized and housing space. A range of parameters were recorded on flock size and their production characteristics such as births, fertility and number of lambs weaned. Milk yield and parameters associated with milk quality, such as somatic cell counts and total microbial flora, were also recorded. Technical intervention was directed towards removal of non-productive animals, programming of matings, balancing of diets, management of grazing lands and health care. Ewe fertility and numbers of lambs weaned per ewe, as well as harvested milk and milk quality (based on somatic cell counts and microbial load of milk) were also significantly improved. Information derived from this study stresses the important role of extension services to small farm sustainability and contributes to our knowledge of the dairy sheep farming systems in countries around the Mediterranean and elsewhere.

The intake and digestion of a range of temperate forages by sheep and fibre-producing goats.

The voluntary intake, digestibility and mean retention time of six temperate forages differing in their chemical composition by 12 adult castrated male Scottish blackface sheep, aged 15 months, and fibre-producing castrated male goats, aged 27 months, and of similar live weight, 40kg, were described. The creation of a range of chemical compositions was effected through the use of barley straw, and a low- and high-digestibility hay, and the use of ammonia treatment of these forages. A wide range of voluntary intakes (42-78gDM/kgW(0.75)/day), digestibility of dry matter (0.46-0.60) and mean retention times of undigested residues (36-72h) was achieved through feeding the six forages. Across all the forages fibre-producing goats had higher voluntary intakes, expressed on a metabolic live weight basis, and lower digestibility values than sheep, whereas the mean retention time of the undigested residues was similar for the two species. Within forages goats selected a diet of potentially higher nutritive value, as predicted from chemical composition, with a smaller particle size than sheep. It was concluded that the differences in intake and digestion of temperate forages between sheep and fibre-producing goats are broadly similar to those observed in other experiments between sheep and goats ingesting tropical forages.

The effect of water availability on feed intake and digestion in sheep.

Six castrated male Karagouniko sheep, offered three levels of water, were used in a 3x3 Latin Square design to study the effects of mild water restriction on roughage intake and digestion. The three treatments were offered water ad libitum throughout the day (A), made available to the animals for 1h daily (B) or 65% of the water consumed ad libitum (C). Sheep in Treatment A consumed more water (181.9g/kg BW(0.75)) than the two water restriction regimes, which did not differ significantly (B: 128.8, C: 117.5g/kg BW(0.75)) between them. Roughage dry matter intake and digestibility of nutrients did not differ significantly between treatments. Non-significant differences (p>0.05) were also observed in the rate of passage of undigested residues between treatments (A: 48.7, B: 56.9 and C: 54.5 %/h). It was concluded that the water restrictions usually applied during the dry season did not have any significant effect on the nutrition of a local breed of sheep in Greece.