Autonomic dysfunction and exercise intolerance in post-COVID-19 - An as yet underestimated organ system?

Individuals recovering from COVID-19 often present with persistent symptoms, particularly exercise intolerance and low cardiorespiratory fitness. Put simply, the Wasserman gear system describes the interdependence of heart, lungs, and musculature as determinants of cardiorespiratory fitness. Based on this system, recent findings indicate a contribution of peripheral, cardiovascular, and lung diffusion limitations to persistent symptoms of exercise intolerance and low cardiorespiratory fitness. The autonomic nervous system as an organ system involved in the pathophysiology of exercise intolerance and low cardiorespiratory fitness, has received only little attention as of yet. Hence, our article discusses contribution of the autonomic nervous system through four potential pathways, namely alterations in (1) cerebral hemodynamics, (2) afferent and efferent signaling, (3) central hypersensitivity, and (4) appraisal and engagement in physical activity. These pathways are summarized in a psycho-pathophysiological model. Consequently, this article encourages a shift in perspective by examining the state of the pulmonary and cardiovascular system, the periphery, and auxiliary, the autonomic nervous system as potential underlying mechanisms for exercise intolerance and low cardiorespiratory fitness in patients with post-COVID-19.

In-vitro Study of the Inhibitory Activity of the Fractions of Onion (Allium cepa) and Shallot Bulb (Allium ascalonicum) Extracts on Angiotensin-Converting Enzyme (ACE)

The impact of hypertension as being the leading cause of death in industrialized societies pressed the importance of low-cost and accessible therapeutic agents present in food sources. This study was undertaken to evaluate the in-vitro Angiotensin-converting Enzyme (ACE) inhibitory activity of flavonoid-rich Onion and Shallot bulb extracts. Ethyl acetate, Butanol and Aqueous fractions of onion and shallot bulb extracts at varying concentrations were obtained through purification by solvent extraction. Positive control was the prototype ACE-inhibitor, Captopril. ACE-inhibitory activity was determined using the ACE-kit commercially manufactured by Dojindo, Inc. (Japan). All fractions of onion and shallot bulb extracts exhibited greater than 50% inhibitory activity towards ACE.  The aqueous fractions of both bulbs showed the highest ACE-inhibitory activity exceeding the flavonoid standard, Quercetin, and were comparable with the prototype ACE-I, Captopril. Based on the study findings, onion and shallot bulbs can be potential sources of bioactive compounds that can inhibit the activity of ACE which can be used to provide a natural, perhaps safer, cost-effective alternative in reducing blood pressure.

Aortic valve replacement via right anterolateral minithoracotomy: preventing adverse events during the initial learning curve

BACKGROUND

Despite excellent outcomes and reduced invasiveness, the right anterolateral thoracotomy approach for aortic valve replacement (RALT-AVR) has not been broadly adopted. This study provides results regarding the initial experience and learning curve of a single surgeon performing this procedure.

METHODS

Periprocedural details and postoperative outcomes of the first 100 consecutive patients who underwent RALT-AVR at our institution were retrospectively analyzed. We conducted a cumulative sum analysis of surgical failure, defined as occurrence of 30-day-mortality, surgical revision for bleeding, conversion to sternotomy, 3^rd degree heart block, paravalvular leakage, postoperative stroke or mean transvalvular gradient >20 mmHg.

RESULTS

The cohort was of low surgical risk (mean EuroSCORE II 1.31%±0.85, mean STS PROM 1.45%±0.97), 58% were males. Median cross-clamp time was 67.5 (57.8-76) min, median CPB time 105 (91.8-119) min, and median operation time 164.5 (144.5-183.2) min. There were no conversions to full sternotomy, 4 cases of revision for bleeding and 2 pacemaker implantations for 3^rd degree heart block. Prosthesis function was good (median ΔPmean 10.9 [7.4-13.6] mmHg). Thirty-day-mortality was 0%. The log-likelihood graph never crossed the upper boundary, and after a steady decrease, crossed the lower boundary at 93 patients.

CONCLUSIONS

RALT-AVR can be performed with acceptable procedural times and satisfactory outcomes. For a well-trained surgeon, adapting to this new procedure does not expose patients to an increased risk, when patient selection and procedural planning are applied appropriately. Cumulative sum failure analysis is an appropriate tool to monitor the transition from standard AVR to the technically more demanding RALT-AVR.

A Global Stochastic Optimization Particle Filter Algorithm

We introduce a new online algorithm for expected loglikelihood maximization in situations where the objective function is multi-modal and/or has saddle points. The key element underpinning the algorithm is a probability distribution which (a) is shown to concentrate on the target parameter value as the sample size increases and (b) can be efficiently estimated by means of a standard particle filter algorithm. This distribution depends on a learning rate, where the faster the learning rate the quicker it concentrates on the desired element of the search space, but the less likely the algorithm is to escape from a local optimum of the objective function. In order to achieve a fast convergence rate with a slow learning rate, our algorithm exploits the acceleration property of averaging, well-known in the stochastic gradient literature. Considering several challenging estimation problems, the numerical experiments show that, with high probability, the algorithm successfully finds the highest mode of the objective function and converges to its global maximizer at the optimal rate. While the focus of this work is expected loglikelihood maximization, the proposed methodology and its theory apply more generally for optimizing a function defined through an expectation.

Development and validation of an HPLC method to be used for simultaneous detection and quantification of different statins after ex vivo skin diffusion studies

A novel high performance liquid chromatography (HPLC) method was developed and validated to simultaneously analyse all statins currently available globally (atorvastatin, fluvastatin, lovastatin, mevastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin). A Venusil XBP C₁₈(2) reverse phase column (150 x 4.6 mm) with a 5 μm particle size was used. The gradient conditions started at 25% acetonitrile, which linearly increased to 90% after 1.0 min, held at 90% until 6.5 min, and lastly, re-equilibrated to starting conditions. The mobile phase consisted of acetonitrile/water and 0.005 M (0.2%) octane sulphonic acid-Na (pH 3.5). The flow rate was set at 1.0 ml/min with a 10 μl injection volume. The HPLC method indicated linearity (R² =0.9999) within the concentration range of 0.2-206.4 μg/ml. The limit of detection (LOD) and limit of quantification (LOQ) values were found to be within the permissible criteria of ≤15% and ≤20%, respectively. Following an appropriate investigation of all the parameters for method validation, it was confirmed that the HPLC method was successfully validated and proven to be accurate to simultaneously quantify statins even in combination with other excipients used during the formulation of nano-emulsions and nano-emulgels.

Physical activity for the treatment and prevention of depression: a rapid review of meta-analyses

Aim: We conducted an umbrella review of 55 meta-analyses to summarize current evidence on the effects of exercise on depression. Results: Aerobic, resistance or combined exercise for several weeks as well as mind-body exercise has shown to yield significant moderate effects on depression severity in adult patients, including the elderly. The effect diminishes when only high-quality studies are analyzed but reaches similar magnitude of other efficacious treatments. Additionally, exercise showed positive effects on sleep, cardiorespiratory fitness and quality of life in depressed patients. In children and adolescents and during the peripartum period, exercise interventions have been found have small-to-moderate effects, but studies varied in methodology and methodical quality could be improved (heterogeneous samples, blinding). Regular physical activity has been shown to have a protective effect on incident depression in adults, reducing odds by 17 to 21%. In children and adolescents, the effect tends to be smaller. Across 15 meta-analyses in samples with physical diseases, exercise-regimes have been shown to have positive effects on depressive symptoms in chronic conditions (such as pain, obesity or cardiovascular disease), cancer survivors, and in post-stroke, neurological and cardiovascular conditions, as well as in diabetes, chronic kidney disease, arthritis and HIV. Discussion: Exercise and physical activity have a wide range of benefits for depression and depressive symptoms in at-risk populations. Further research is needed to find optimal dose and duration of exercise-treatment and ways to sustainably increase physical activity in psychiatric populations and patients with chronic diseases. Key Words: Exercise, Aerobic, Resistance, Depressive Symptoms, At-Risk Population

[Survey among livestock veterinarians from the Canton of Fribourg investigating the topics of herd-health management, counselling and the use of antimicrobial drugs]

INTRODUCTION

The work of veterinarians is continuously undergoing structural changes. A shift from purely curative individual animal care towards herd-health management is observed worldwide in the livestock sector. To illustrate the practical implementation with all its advantages and disadvantages, an online survey was conducted among all practicing livestock veterinarians in the Canton of Fribourg. A link to the survey was sent by email, it was voluntary and possible to complete the questionnaire anonymously. The survey focused on four topics: Demographic data, herd-health management, billing of counselling and use of antimicrobial drugs. Forty veterinarians from at least 79.2% (n = 19) of all veterinary practices located in the canton of Fribourg (n = 24) responded. Of these, 67.5% were practice owners or partner (n = 27) and 32.5% were employed veterinarians (n = 13). In Fribourg, only herd fertility management is included in the herd-health management on a regular basis. The quality and quantity of advanced trainings in herd-health management for veterinarians was assessed as moderate to poor. There are various options for charging herd-health management services. The amount charged was variable. The most frequently used options were hourly rates (100-300 CHF/h), "rate per cow per year excl. visit rate" (22-75 CHF/cow/year) or "rate per cow per year incl. visit rate" (85-98 CHF/ cow/year). Only one veterinarian (2.5%) charges for advisory activities not included in the the herd-health management service, which was asked for separately. However, the time required for counselling (excluding herd-health management) was estimated to be between 5.0-70.0% of the total working time (median 15.0%, interquartile range = 10.0-32.5%). Veterinarians in Fribourg are reHauptluctant to follow the international trend towards a regular, integrated herd-health management. The majority of them do not charge for consultancy outside the herdhealth management service. A nationwide survey should be considered to better assess the situation all over Switzerland.

A novel HPLC method developed and validated for the detection and quantification of atorvastatin, fluvastatin, pitavastatin and pravastatin during transdermal delivery studies

An HPLC method was developed and validated to quantify and identify several statins (atorvastatin, fluvastatin, pitavastatin and pravastatin) that were used during transdermal drug delivery. The method proved to be most effective with a Restek Ultra C₁₈, 250 x 4.6 mm, 5 μm column, a flow rate of 1.0 ml/min, UV detection at 240 nm and injection volume of 10 μl. The mobile phase used was acetonitrile/Milli-Q^® water with 0.1% orthophosphoric acid starting with 30% acetonitrile, which increased linearly to 70% (after 4 min) for up to 10 min and then re-equilibrated to start conditions. This HPLC method indicated linearity (correlation coefficient (R²) of 1) within the concentration range of 0.05-200.00 μg/ml and had an average recovery of 98-103%. Limit of detection (LOD) and limit of quantification (LOQ) showed that statins could still be identified at concentrations of 0.004-0.006 μg/ml with the exception of atorvastatin (quantifiable at 0.013-0.035 μg/ml). Specificity performed during method validation, confirmed that the method was suitable for accurate detection and quantification of the statins when included in the transdermal formulations with other excipients.

Vulnerable Narcissism as Key Link Between Dark Triad Traits, Mental Toughness, Sleep Quality and Stress

Introduction

The concept of the Dark Triad (DT) consists of the dimensions of Machiavellianism, narcissism, and psychopathy, and has gained increased interest within the last 15 years for its predictive power to explain success in the fields of economy, politics, and professional sport. However, recent research suggests that the associations between DT and behavior are not as uniform as expected.

Aims

Investigating the associations between DT traits and vulnerable narcissism, mental toughness, sleep quality, and stress perception.

Methods

A total of 720 participants between 18 and 28 years took part in the study. The sample consisted of military cadres in the US (n = 238), Switzerland (n = 220), and of students from the university of Basel (n = 262). Participants completed self-rating questionnaires covering DT traits, mental toughness, vulnerable narcissism, sleep quality, and perceived stress.

Results

Irrespective of the sample, participants scoring high on vulnerable narcissism also reported higher DT traits, lower mental toughness, poor sleep quality, and higher scores on perceived stress.

Conclusions

The present pattern of results suggests a more fine-grained association between DT traits and further behavior, calling into question to what extent DT traits might be a predictor for greater success in the fields of economy, politics or elite sports. Specifically, vulnerable narcissism seems to be key for more unfavourable behavior.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Assessing physical activity in people with mental illness: 23-country reliability and validity of the simple physical activity questionnaire (SIMPAQ)

BACKGROUND

Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness.

METHODS

The five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in people living with mental illness. Patients with a DSM or ICD mental illness diagnoses were recruited and completed the SIMPAQ on two occasions, one week apart. Participants wore an Actigraph accelerometer and completed brief cognitive and clinical assessments.

RESULTS

Evidence of SIMPAQ validity was assessed against accelerometer-derived measures of physical activity. Data were obtained from 1010 participants. The SIMPAQ had good test-retest reliability. Correlations for moderate-vigorous physical activity was comparable to studies conducted in general population samples. Evidence of validity for the sedentary behaviour item was poor. An alternative method to calculate sedentary behaviour had stronger evidence of validity. This alternative method is recommended for use in future studies employing the SIMPAQ.

CONCLUSIONS

The SIMPAQ is a brief measure of physical activity and sedentary behaviour that can be reliably and validly administered by health professionals.

Physical fitness and nutritional anthropometric status of children from disadvantaged communities in the Nelson Mandela Bay region

Background

Information about the relationships between physical fitness, body composition and nutrition has increased in recent years; however, little is known about physical fitness and the coexistence of under-/overnutrition among children living in disadvantaged areas.

Objectives

To determine the physical fitness status and its association with body composition, growth and selected socio-demographics in primary schoolchildren from disadvantaged communities in the Nelson Mandela Bay region.

Methods

Nine hundred and sixty-five children (49% girls, M=9.5 years) participated in this cross-sectional study. Height and weight were measured to establish body mass index, and height-for-age z-scores. Physical fitness was assessed using tests from the Eurofit Physical Fitness test battery (flexibility, upper/lower body muscular strength and cardiorespiratory fitness). Between-group differences and cross-sectional associations were examined with univariate (Chi²-tests, analyses of variance) and multivariate methods (mixed linear/logistic regression).

Results

Most children had normal weight (76.7%), while 4.5% were underweight and 18.7% were overweight/obese. Underweight children and children with stunted growth (11.5%) had lower average upper body strength (p<0.001). Overweight/obese children had lower scores in weight-bearing activities (p<0.001). Children with higher socio-economic status were more likely to be overweight and obese (p<0.001). In the multivariate analyses, sex, age, body mass index, and stunting were associated with children's physical fitness.

Conclusion

Fitness assessments seem to be a relevant measure of the current health status of children in disadvantaged settings. Compared to international norms, the children in this study had relatively low scores for both upper- and lower body muscular strength. Therefore, effective school-based intervention programmes should be developed to improve children's physical fitness in disadvantaged schools.

Determination of lovastatin, mevastatin, rosuvastatin and simvastatin with HPLC by means of gradient elution

A novel HPLC method with UV detection was developed and validated in skin penetration (in vitro) studies to identify and quantify lovastatin, mevastatin, rosuvastatin and simvastatin. A Venusil XBP C₁₈ (2), 150 x 4.6 mm, 5 μm column (Agela Technologies, Newark, DE) was used with gradient elution (start at 45 % acetonitrile and increase linearly to 90 % after 1 min; hold at 90 % until 6 min and then re-equilibrate at start conditions) and the mobile phase consisted of (A) Milli-Q ® water and 0.1% orthophosphoric acid, and (B) HPLC grade acetonitrile. The flow rate was set at 1 ml/min, 240 nm UV detection and an injection volume of 10 μl. Linearity was obtained over a range of 0.50-200.00 μg/ml and correlation coefficients ranging from 0.998-1.000 were obtained. Average recovery ranged from 95.9-100.6 %. The LOD and LOQ values obtained from the slope of a calibration curve and the standard deviation of the response ranged from 0.0138-0.0860 μg/ml and 0.0419-0.2615 μg/ml, respectively, where lovastatin and simvastatin could be detected at a concentration similar to the other statins, but could only be quantified at a higher concentration than the remaining statins. The specificity of the method was proved as accurate and quantification of statins was found, even within the incorporation of other compounds.

A Combined EEG-fNIRS Study Investigating Mechanisms Underlying the Association between Aerobic Fitness and Inhibitory Control in Young Adults

The current evidence suggests that aerobic fitness is associated with inhibitory control of executive functioning in children and older adults. However, the relative contributions of different neurophysiological mechanisms to this relation remain unclear and have not yet been examined in young adults. The present study aimed to compare inhibitory control between high and low-fit young adult men, and to investigate a possible mediation of fitness effects by conflict monitoring (N450 component of event-related potentials) and lateralized oxygenation difference (LOD) in the DLPFC. For the present cross-sectional study, participants with different physical activity levels were recruited and divided into low-fit and high-fit participants based on relative power on the PWC170. A Stroop Color-Word task was administered and combined EEG-fNIRS was simultaneously utilized to assess the N450 and LOD, because these parameters are linked with behavioral performance. The results of the statistical analysis showed that high-fitcompared to low-fit participants showed less Stroop interference and lower negativity of the N450, whereas no difference was found for LOD. Path-analyses further revealed that the relation between aerobic fitness levels and Stroop interference was indirect and mediated by N450. In contrast, LOD was inversely correlated with Stroop interference, but did not explain the relation of aerobic fitness with behavioral performance. The present findings indicate that greater inhibitory control in high- compared to low-fit young men can be explained by more effective conflict monitoring. Moreover, young adults with left-lateralizedDLPFC oxygenation also show higher inhibitory control, but this oxygenation pattern is not influenced by aerobic fitness.

Development and validation of the simultaneous determination of artemisone, clofazimine and decoquinate with HPLC

The aim of this study was to develop and validate a novel HPLC method for the simultaneous analysis of artemisone, clofazimine and decoquinate. Detection was obtained at two wavelengths; 284 nm (clofazimine) and 210 nm (artemisone and decoquinate). Gradient elution was used with mobile phase A (A) consisting of 0.005 M sodium octanesulphonic-acid (pH 3.5) and mobile phase B (B) of HPLC grade acetonitrile. The flow rate was set to 1.0 ml/min with (A) at 35% and (B) at 65% for 2 min, followed by a gradient shift of 10/90% ((A)/(B)) over a duration of 4 min. After 10 min, the initial gradient conditions were readjusted to 35/65% ((A)/(B)). Distinctive peaks were identified for clofazimine, artemisone and decoquinate, respectively. The proposed HPLC assay method was validated and found to be reliable, reproducible and accurate for simultaneous analysis of the three compounds.

Dynamic behavior of different quantities of osteoblasts during formation of micromass cultures

Implantation of micromass cultures of osteoblastic cells offers the possibility of scaffold free tissue engineering for example, regeneration of bone defects. However, the details of cell dynamics during the formation of these micromasses are still not well understood. This study aims to investigate and clarify the extent to which cell quantity influences the dynamics of micromass formation of osteoblastic cell cultures. For this purpose, the migration and aggregation during this process are investigated by optical inspection employing image processing software that allows for automated tracking of cell groups using digital image correlation. An exponential time behavior is observed with respect to the velocity of the cells and the distance of the cells to their common center of gravity. Characteristic time constants are derived as quantitative measures of the cell dynamics. The results indicate that the time constants strongly depend on the quantity of cells, that is, will decrease with increasing cell quantity. © 2018 International Society for Advancement of Cytometry.

The origins of mental toughness–internalizing and externalizing problems at the age of 5 years predict higher mental toughness scores at the age of 14 years

Background

The concept of mental toughness has gained increasing importance among non-elite athletes for its psychological importance and explanatory power for a broad range of health-related behaviors. On the flip side, no study has focused so far on the psychological origins of mental toughness. Therefore, the aims of the present study were three-fold: to explore, to what extent psychological profiles of preschoolers at the age of five years predicted mental toughness scores and sleep disturbances at the age of 14 years, and to explore possible gender differences.

Method

Nine years after their first assessment at the age of five years (preschoolers), a total of 77 adolescents (mean age: 14.35 years; SD = 1.22; 42% females) took part in the present follow-up study. At baseline, both parents and teachers completed the Strengths and Difficulties Questionnaire (SDQ), covering internalizing and externalizing problems, hyperactivity, negative peer relationships, and prosocial behavior. At follow-up, participants completed a booklet of questionnaires covering socio-demographic data, mental toughness, and sleep disturbances.

Results

Preschoolers with high prosocial behavior and low internalizing and externalizing problems, as rated by parents and teachers, at the age of 14 years self-reported higher mental toughness and lower sleep disturbances. At the age of 14 years, and relative to their male counterparts, female participants reported lower MT scores and higher sleep disturbances.

Conclusions

The pattern of results suggests that mental toughness traits during adolescence have their origins during pre-school years.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Aerobic Exercise Training in Children and Adolescents with Inflammatory Bowel Disease: Influence on psychological Functioning, Sleep and Physical Performance

Background and aims

Patients with inflammatory bowel disease (IBD) report increased mental health issues, poorer sleep quality and less engagement in physical activity (PA). Standard treatment consists of immune modulating pharmaceuticals, though evidence is growing that aerobic exercise training (AET) might serve as adjuvant option to reduce disease symptoms and improve mental health. The aim of the present study was to investigate possible AET effects on psychological functioning, depressive symptoms, sleep and PA behavior in paediatric patients with IBD.

Methods

Twenty-one paediatric patients with IBD and 23 gender and age-matched healthy controls (HC) were assessed. The IBD group was split into a “remission-group” (IBD-RE; n = 14) and an “active disease group” (IBD-AD; n = 7). All participants completed an 8-week AET exergame intervention reaching 60–80% of maximal heart rate for 5 days per week. At baseline and after 8 weeks, psychological functioning, depressive symptoms, objective sleep EEG, subjective sleep and objective and subjective PA were assessed.

Results

AET significantly improved the exercise capacity of all participants. Self-reported fitness and daily PA behavior significantly increased in IBD-AD, but not in IBD-RE and HC. No improvements were observed for psychological functioning, depressive symptoms and subjective or objective sleep dimensions. Descriptively, the IBD-AD group reported lower psychological functioning and poorer subjective sleep quality.

Conclusions

Results suggest that children and adolescents in an active disease state were at increased risk to descriptively report lower scores of psychological functioning and sleep. Further, an exergaming intervention has the potential to improve exercise capacity, self-reported fitness and daily PA.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Longitudinal Changes in Sleep Disturbances, Mental Toughness, and Physical Activity in Patients with Multiple Sclerosis

Background

Multiple sclerosis (MS) is a chronic progressive autoimmune disease. Fatigue, depression and cognitive impairments are the most common symptoms of patients with MS. Whereas there is extant research on fatigue, depression, and cognitive impairment of patients with MS during the clinical course, no research focused on the long term changes of psychological functioning, sleep problems, and physical activity on these patients. The aims of the present study were therefore to examine changes in physical activity, sleep disturbances, and mental toughness over a 1.5-year period of time in people with multiple sclerosis after the onset their MS.

Methods

A total of 18 patients with diagnosed MS (mean age: M = 33.61 years) took part in this study. They completed a booklet of questionnaires covering socio-demographic data, mental toughness, sleep disturbances, and physical activity, at the onset of disease and 1.5 years later.

Results

In total, 1.5 years after the onset of MS, patients had lower levels of vigorous physical activity, but not statistically significant change in moderate physical activity. Patients with sleep disturbances at the onset of disease had statistically significant sleep disturbances also 1.5 years later.

Conclusions

Compared to the onset of disease, 1.5 years later, patients with MS reported similar mental toughness traits, sleep disturbances and levels of moderate physical activity. The pattern of results of the present pilot study suggests that the onset of MS is not an obstacle for doing moderate physical activity. Based on the result of this study, sleep disturbances remains stable by time.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Sleep disturbances, mental toughness, and physical activity in patients with multiple sclerosis (MS) compared to healthy adolescents and young adults

Background

Multiple sclerosis (MS) is the commonest chronic autoimmune demyelinating and inflammatory disease of the CNS, afflicting both body and mind. Typical symptoms are fatigue, paraesthesia and depression, along with cognitive impairments. Whereas there is extant research on fatigue, depression, and cognitive impairment of patients with MS during the clinical course, no research focused on sleep, psychological functioning, and physical activity (PA) at the moment of the diagnose. The aims of the present study were therefore to assess possible state markers of mental toughness (MT) as a dimension of psychological functioning, sleep disturbances (SD), PA among patients at the moment of the diagnose, and to compare these data with those of healthy adolescents and healthy young adults.

Methods

A total of 23 patients with recently diagnosed MS (M = 32.31 years), 23 healthy adolescents (M = 17.43 years), and 25 healthy young adults (M = 20.72 years) took part in the study. They completed questionnaires covering socio-demographic data, MT, SD, and PA.

Results

Patients with MS reported similar MT traits as adolescents, and an equal amount of moderate PA and SD as young adults. Further, patients reported a lower level of vigorous PA, compared to healthy adolescents and young adults.

Conclusions

Compared to healthy adolescents and young adults, patients at the moment of the diagnose of MS reported similar MT traits, SD and moderate PA. The pattern of results suggests that at the moment of the diagnose MS is not predictable by poor MT, poor sleep, and decreased level of moderate PA.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Common Femoral Artery — Uncommon Aneurysms

Background and Aims:

Femoral artery aneurysms are rare. Their natural history, tendency to embolize or rupture are not well known.

Material and Methods:

Data of all patients seen 1996–2002 with femoral artery aneurysms at the Swiss Cardiovascular Center were analysed. Nine patients with 13 aneurysms of the common femoral artery (CFA) were identified. Only true aneurysms with a diameter of at least 2.5 cm were included. All patients were male, mean age 70 years (range: 57–85 years). Four patients had bilateral femoral aneurysms. Risk factors included hypertension (9/9), smoking (7/9). One of the aneurysms was palpable in 5/9. Four patients were asymptomatic, 5 had Fontaine class II claudication. Five patients also had an aortic aneurysm (AAA), one a thoracic aneurysm; and 6/9 popliteal aneurysms. In all patients, diagnosis was confirmed with duplex scan. Angiography was performed preoperatively.

Results:

The aneurysms were operated on electively using aneurysm secclusion and interposition grafting. There were no significant perioperative complications. Median hospital stay was 8 days.

Conclusion:

CFA aneurysms are rare. They are palpable in nearly half of the cases. They rarely cause thrombotic or embolic complications, but are almost always connected to other aneurysms. Patients with CFA aneurysms should be screened with duplex scan. Operative therapy is straightforward, few complications can be expected. Postoperative follow-up with annual duplex scans is suggested.

Exploratory data analysis of the dependencies between skin permeability, molecular weight and log P

Molecular weight and log P remain the most frequently used physicochemical properties in models that predict skin permeability. However, several reports over the past two decades have suggested that predictions made by these models may not be sufficiently accurate. In this study, exploratory data analysis of the probabilistic dependencies between molecular weight, log P and log Kp was performed on a dataset constructed from the combination of several popular datasets. The results suggest that, in general, molecular weight and log P are poorly correlated to log Kp. However, after employing several exploratory data analysis techniques, regions within the dataset of statistically significant dependence were identified. As an example of the applicability of the information extracted from the exploratory data analyses, a multiple linear regression model was constructed, bounded by the ranges of dependence. This model gave reasonable approximations to log Kp values obtained from skin permeability studies of selected non-steroidal ant-inflammatory drugs (NSAIDs) administered from a buffer solution and a lipid-based drug delivery system. A method of testing whether a given drug falls within the regions of statistical dependence was also presented. Knowing the ranges within which molecular weight and log P are statistically related to log Kp can supplement existing methods of screening, risk analysis or early drug development decision making to add confidence to predictions made regarding skin permeability.

A novel RP-HPLC method for the detection and quantification of roxithromycin in topical delivery studies

A novel HPLC method with UV detection for the identification and quantification of roxithromycin (ROX) during in vitro skin penetration studies has been developed and validated. The method proved to be simple and rapid with isocratic elution (flow rate: 1.0 mL/min) of ROX, using a C18 column and UV detection at 205 nm. The mobile phase consisted of 0.06 M potassium di-hydrogen orthophosphate buffer (pH adjusted to 7.4 with sodium hydroxide) and acetonitrile in a 50:50 (v/v) ratio. This method showed linearity across the concentration range of 5 - 1000 μg/mL with a correlation coefficient of 0.9999. An average recovery of 101.78% was obtained. Limit of detection (LOD) and lower limit of quantification (LLOQ) values proved that ROX can still be detected at a concentration level of 0.3 μg/mL and accurately quantified at a concentration of 0.5 μg/mL. The specificity testing during method validation proved that this method is suitable for the accurate detection and quantification of ROX even when combined with different compounds typically used during the formulation of topical delivery systems.

Contribution of physical education to overall physical activity

For many children, physical activity (PA) during physical education (PE) lessons provides an important opportunity for being physically active. Although PA during PE has been shown to be low, little is known about the contribution of PA during PE to overall PA. The aim was therefore to assess children's PA during PE and to determine the contribution of PE to overall PA with special focus on overweight children. Accelerometer measurements were done in 676 children (9.3 ± 2.1 years) over 4-7 days in 59 randomly selected classes. Moderate-and-vigorous PA (MVPA; ≥ 2000 counts/min) during PE (MVPAPE), overall MVPA per day (MVPADAY), and a comparison of days with and without PE were calculated by a regression model with gender, grade, and weight status (normal vs overweight) as fixed factors and class as a random factor. Children spent 32.8 ± 15.1% of PE time in MVPA. Weight status was not associated to MVPAPE . MVPAPE accounted for 16.8 ± 8.5% of MVPADAY, and 17.5 ± 8.2% in overweight children. All children were more active on days with PE than on days without PE (differences: 16.1 ± 29.0 min of MVPADAY; P ≤ 0.001; 13.7 ± 28.0 min for overweight children). Although MVPAPE was low, PE played a considerable role in providing PA and was not compensated by reducing extracurricular MVPA.

Return of olfaction after gross total resection of an olfactory groove meningioma: case report

Patients with olfactory, groove meningiomas may present with anostnia, Surgery in patients with intact olfaction can also lead to anosmia when the olfactory nerves are sacrified. Olfaction can be preserved by using the prerional approach and microsurgical technique. To our knowledge; however, the recovery of olfaction after resection of an olfactory groove meningroma has not been reported. We therefore describe a patient who presented with anosmia whose evaluation revealed a large olfactory groove meningioma. She underwent a bifrontal approach for microsurgical gross bilateral excision of the tumor. At her 6-month follow-up examination, her olfaction, as measured by formal testing, had recovered.