Longitudinal functional connectivity changes correlate with mood improvement after regular exercise in a dose‐dependent fashion

Exercise increases wellbeing and improves mood. It is however unclear how these mood changes relate to brain function. We conducted a randomized controlled trial investigating resting‐state modifications in healthy adults after an extended period of aerobic physical exercise and their relationship with mood improvements. We aimed to identify novel functional networks whose activity could provide a physiological counterpart to the mood‐related benefits of exercise. Thirty‐eight healthy sedentary volunteers were randomised to either the aerobic exercise group of the study or a control group. Participants in the exercise group attended aerobic sessions with a physiotherapist twice a week for 16 weeks. Resting‐state modifications using magnetic resonance imaging were assessed before and after the programme and related to mood changes. An unbiased approach using graph metrics and network‐based statistics was adopted. Exercise reduced mood disturbance and improved emotional wellbeing. It also induced a decrease in local efficiency in the parahippocampal lobe through strengthening of the functional connections from this structure to the supramarginal gyrus, precentral area, superior temporal gyrus and temporal pole. Changes in mood disturbance following exercise were correlated with those in connectivity between parahippocampal gyrus and superior temporal gyrus as well as with the amount of training. No changes were detected in the control group. In conclusion, connectivity from the parahippocampal gyrus to motor, sensory integration and mood regulation areas was strengthened through exercise. These functional changes might be related to the benefits of regular physical activity on mood.     

Effect of pacifier use on oral breathing in healthy newborn infants

We tested the hypothesis that the use of a pacifier may affect the ability of some term infants to maintain effective oral breathing during prolonged nasal occlusion. Three nasal occlusion tests without a pacifier and 3 with a pacifier were alternately carried out in 20 healthy term infants (age 2-5 days). Once the infant commenced oral breathing, nasal occlusion was continued for up to 90 sec (prolonged nasal occlusion), provided the infant did not start crying and that arterial oxygen saturation (SaO(2)) did not drop to < or = 80%. The response to nasal occlusion was considered maladaptive if oral breathing was accomplished with signs of upper airway obstruction. After nasal occlusion, the infants succeeded in starting oral breathing in all instances after a delay which was strongly correlated to the drop in SaO(2) (P < 0.001). Once the infants commenced oral breathing, 17/20 infants presented a maladaptive response to 62% of all tests without pacifier, whereas 10/20 infants presented a maladaptive response to 30% of all tests with a pacifier in place (P < 0.001). Following prolonged nasal occlusion, 18 of 19 infants presented a maladaptive response to 84% of all tests without pacifier, whereas 12 of 19 infants presented a maladaptive response to 41% of all tests with a pacifier in place (P < 0.001). Thus, after prolonged nasal occlusion with or without pacifier, the drop in mean SaO(2) from baseline values changed in accordance with an appropriate and maladaptive response (-4 +/- 1 vs. -7 +/- 1; P < 0.001). We conclude that normal term infants often present with a maladaptive response to prolonged nasal occlusion. The use of a pacifier enhances the infant's ability to maintain a more adequate oral air flow.     

Continuous evidence of fast HIV disease progression related to class-wide resistance to antiretroviral drugs: a 6 year follow-up analysis of a large observational database

Class-wide resistance (CWR) was increasingly associated with a higher risk of HIV progression after 72 months of follow-up among 1392 patients genotypic-tested after failure (AIDS risk 13% for no CWR to 34% for three CWR; AIDS/death risk 21-54%). At multivariate analysis, the detection of two and three CWR was significantly associated with a two and threefold increased risk, respectively, of death and AIDS/death, suggesting that extended resistance is a marker of disease progression in long-term observation.     

Alpha-5/alpha-3 nicotinic receptor subunit alleles increase risk for heavy smoking

Twin studies indicate that additive genetic effects explain most of the variance in nicotine dependence (ND), a construct emphasizing habitual heavy smoking despite adverse consequences, tolerance and withdrawal. To detect ND alleles, we assessed cigarettes per day (CPD) regularly smoked, in two European populations via whole genome association techniques. In these approximately 7500 persons, a common haplotype in the CHRNA3-CHRNA5 nicotinic receptor subunit gene cluster was associated with CPD (nominal P=6.9 x 10(-5)). In a third set of European populations (n= approximately 7500) which had been genotyped for approximately 6000 SNPs in approximately 2000 genes, an allele in the same haplotype was associated with CPD (nominal P=2.6 x 10(-6)). These results (in three independent populations of European origin, totaling approximately 15 000 individuals) suggest that a common haplotype in the CHRNA5/CHRNA3 gene cluster on chromosome 15 contains alleles, which predispose to ND.     

The Vascular Join: a new sutureless anastomotic device to perform end-to-end anastomosis. Preliminary results in an animal model

Standard vascular techniques don't meet new surgeons' needs for the more complex vascular reconstructions, minimal invasive approaches and robotic surgery. Therefore, alternative ways to perform vascular anastomosis are always welcome. We present a new sutureless vascular connector and the first animal study. The Vascular Join consists of two metallic rings fixed to the extremity of two conduits being joined together, connected with a snap-on system. The key element that makes this device different from all other sutureless devices is that there is no foreign material inside the vessel lumen. In 10 adult sheep, both carotid arteries were prepared and severed after heparinisation. Twenty end-to-end vascular anastomoses were performed and controlled with intravascular ultrasound and colour-Doppler. Animals were sacrificed and a histopathological analysis was carried out. All anastomoses were successfully completed without bleedings, stenosis or occlusions. The histological results confirmed the perfect vessel edges apposition and absence of foreign material in the vessel lumen. The intimal layer was intact. Vascular Join can easily perform sutureless end-to-end anastomoses and it can be used either with biological or prosthetic materials. Further animal studies are underway to assess the long-term results. Following the same technical criteria, we are developing an end-to-side anastomotic device.     

Laparoscopic surgery for gynaecological cancers in obese women

The use of laparoscopic surgery in the management of gynaecological malignancies has been growing for over a decade. Concomitantly the incidence of obesity has been increasing worldwide. This review summarizes the available studies on minimal invasive surgery in obese women with gynaecological malignancies. We undertook a literature search to identify the differences between traditional open methods and the laparoscopic approach in terms of intra- and postoperative outcome and patient safety. Only eight relevant studies were identified. Six of these focused on endometrial cancer, one study included early stage cervical and ovarian cancers with other benign conditions, while another paper included cervical and endometrial pre-cancers and only a few malignant conditions.