Referred pain from myofascial trigger points in head and neck–shoulder muscles reproduces head pain features in children with chronic tension type headache

Our aim was to describe the referred pain pattern and areas from trigger points (TrPs) in head, neck, and shoulder muscles in children with chronic tension type headache (CTTH). Fifty children (14 boys, 36 girls, mean age: 8 ± 2) with CTTH and 50 age- and sex- matched children participated. Bilateral temporalis, masseter, superior oblique, upper trapezius, sternocleidomastoid, suboccipital, and levator scapula muscles were examined for TrPs by an assessor blinded to the children’s condition. TrPs were identified with palpation and considered active when local and referred pains reproduce headache pain attacks. The referred pain areas were drawn on anatomical maps, digitalized, and also measured. The total number of TrPs was significantly greater in children with CTTH as compared to healthy children (P < 0.001). Active TrPs were only present in children with CTTH (P < 0.001). Within children with CTTH, a significant positive association between the number of active TrPs and headache duration (rs = 0.315; P = 0.026) was observed: the greater the number of active TrPs, the longer the duration of headache attack. Significant differences in referred pain areas between groups (P < 0.001) and muscles (P < 0.001) were found: the referred pain areas were larger in CTTH children (P < 0.001), and the referred pain area elicited by suboccipital TrPs was larger than the referred pain from the remaining TrPs (P < 0.001). Significant positive correlations between some headache clinical parameters and the size of the referred pain area were found. Our results showed that the local and referred pains elicited from active TrPs in head, neck and shoulder shared similar pain pattern as spontaneous CTTH in children, supporting a relevant role of active TrPs in CTTH in children

String C-groups of order 1024

This paper determines the nondegenerate string C-groups of order 1024. For groups of rank 3, we use the technique of central extension of string C-groups of order 512. For groups of rank at least 4, we compute for quotients of universal string C-groups

Symmetry Groups Associated With Tilings on a Flat Torus

This work investigates symmetry and color symmetry properties of Kepler, Heesch and Laves tilings embedded on a flat torus and their geometric realizations as tilings on a round torus in Euclidean 3-space. The symmetry group of the tiling on the round torus is determined by analyzing relevant symmetries of the planar tiling that are transformed to axial symmetries of the three-dimensional tiling. The focus on studying tilings on a round torus is motivated by applications in the geometric modeling of nanotori and the determination of their symmetry groups

Diagnóstico citológico de las recidivas tumorales de ameloblastoma: presentación de dos casos clínicos

Introducción: Los ameloblastomas son los tumores odontogénicos más frecuentes del maxilar. A pesar de su aspecto citohistológico de benignidad, se comportan como tumores invasivos, recidivantes y con posibilidad de metastatizar. La P.A.A.F. es una prueba rápida e incruenta que proporciona un diagnóstico prequirúrgico evitando, en ocasiones, tomas biópsicas destinadas al diagnóstico. Presentamos las características citológicas de dos casos de recidiva yugal de ameloblastoma de rama mandibular diagnosticados por PAAF, así como su correlación citohistológica. Casos clínicos: Dos pacientes, una mujer de 36 años y un varón de 62 años, que acuden por tumoración mandibular de escasos meses de evolución. En ambos casos, la primera aproximación diagnóstica fue junto a los estudios radiológicos el estudio histológico de la masa tumoral. Tras la extirpación terapeútica, ambos casos recidivaron. El diagnóstico de las recidivas fue establecido citológicamente mediante PAAF. Las extensiones citológicas mostraron un fondo granular con aislados macrófagos y células multinucleadas gigantes y una abundante celularidad epitelial de aspecto basaloide dispuesta en grupos cohesivos configurando imágenes de empalizada periférica, así como pequeños grupos de células de metaplasia escamosa. Discusión: La PAAF se considera como un método diagnóstico rápido, incruento y fiable en el diagnóstico del ameloblastoma. La citología de estos tumores revela los componentes de la lesión que, en general, son suficientes para llegar al diagnóstico de ameloblastoma, especialmente en casos de recidiva.Introduction: Ameloblastomas are the most frequent odontogenic tumors of the maxilla. In spite of their benign cytohistological appearance, they behave as invasive recurring tumors, with the possibility of metastasis. FNAB is a rapid, bloodless test that provides a pre-surgical diagnosis, thus, on occasions avoiding the need for diagnostic biopsies. We present the cytological characteristics of two cases of jugal recurrences of mandibular ameloblastomas diagnosed by FNAB, as well as their cytohistological correlation. Clinical cases: Two patients, a 36-year-old woman, and a 62- year-old male who both attended with mandibular swelling of a few months evolution. In both cases the first diagnostic approximation was the histological study of the tumoral mass, together with the radiological studies. Following therapeutic extirpation both cases recurred. The diagnosis of the recurrences was established cytologically by means of FNAB. The cytologic smears revealed a granular background with isolated macrophages and giant multinucleate cells and an abundant epithelial cellularity of basaloid appearance arranged in cohesive groups forming images of peripheral palidasing, as well as small groups of squamous metaplastic cells. Discussion: FNAB is considered to be a rapid, bloodless and reliable method for the diagnosis of ameloblastoma. The cytology of these tumors reveals components of the lesion that, in general, are sufficient for the diagnosis of ameloblastoma, especially in cases of recurrence

Exercises and Dry Needling for Subacromial Pain Syndrome: a Randomized Parallel- Group Trial.

This randomized clinical trial investigated the effectiveness of exercise vs. exercise plus trigger point dry needling (TrP-DN) in subacromial pain syndrome. A randomized parallel-group trial, with 1-year follow-up was conducted. Fifty subjects with subacromial pain syndrome were randomly allocated to receive exercise alone or exercise +TrP-DN. Participants in both groups were asked to perform an exercise program of the rotator cuff muscles twice daily for 5 weeks. Further, patients allocated to the exercise +TrP-DN group also received dry needling to active TrPs in the muscles reproducing shoulder symptoms during the 2nd and 4th sessions. The primary outcome was pain-related disability assessed with the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Secondary outcomes included mean current pain and the worst pain experienced in the shoulder during the previous week. They were assessed at baseline, one week, and 3, 6, and 12 months after the end of treatment. Analysis was by intention to treat with mixed ANCOVA adjusted for baseline outcomes. At 12 months, 47 (94%) patients completed follow-up. Statistically larger improvements (all, P<0.01) in shoulder disability was found for the exercise +TrP-DN group at all follow up periods [post: Δ -20.6 (-23.8 to -17.4); 3 months: Δ -23.2 (-28.3 to -18.1); 6 months: Δ -23.6 (-28.9 to -18.3); 12 months: Δ -13.9 (-17.5 to -10.3). Both groups exhibited similar improvements in shoulder pain outcomes at all follow-up periods. The inclusion of TrP-DN to an exercise program was effective for improving disability in subacromial pain syndrome. No greater improvements in shoulder pain were observed.pre-print2407 K

An approach to the toxicity and toxicokinetics of aflatoxin B1 and ochratoxin A after simultaneous oral administration to fasted F344 rats

Humans are exposed to the hepatotoxic aflatoxin B1 (AFB1) and nephrotoxic ochratoxin A (OTA) through diet. However, kinetic and toxicological data after their co-administration are scarce. In this study, a single oral dose of AFB1 (0.25mg/kg bw)+OTA (0.5mg/kgbw) was administered to fasted F344 rats. Blood, liver and kidney were harvested at different timepoints for mycotoxins quantification, relative weight calculation, clinical biochemistry and histopathology analysis. Toxicity parameters pointed to acute toxicity in liver due to AFB1. No remarkable toxicity was observed in kidneys or immunological organs. Maximum observed concentrations in plasma (C(max)) were at 10min and 2h for AFB1 and OTA, respectively. AFB1 plasma concentration could indicate a rapid absorption/ metabolism of the mycotoxin; and AFB1 liver and kidney concentrations were lower than LOQ and LOD, respectively. For OTA, C(max) was 4326.2μg/L in plasma. In kidney and liver C(max) was reached at 8h and concentrations were very similar between both organs at all timepoints. Due to the low levels of AFB1, the effect of OTA on AFB1 kinetics could not be assessed. However, AFB1 seems not to affect OTA kinetics, as its profile seems very similar to kinetic studies performed only with OTA in similar conditions