Randomized trial of the efficacy of bright-light exposure and aerobic exercise on depressive symptoms and serum lipids

BACKGROUND: Season-related subsyndromal depressive symptoms during winter are common among populations at high latitudes. Both physical exercise and exposure to bright light can relieve the fatigue and downturn of mood associated with the shortening length of day. Serum cholesterol level may be related to changes in mood, but the evidence is contradictory. Our objective was to compare the effect of aerobic exercise with or without bright-light exposure on health-related quality of life, mood, and serum lipids in a sample of relatively healthy adult subjects. METHOD: A randomized controlled trial was conducted with subjects allocated to group aerobics training in a gym with bright light (2500-4000 lux) (N = 40) or normal illumination (N = 42) or to relaxation/stretching sessions in bright light as a control group (N = 42) twice a week for a period of 8 weeks. Changes in mood were recorded using questionnaires at the beginning of the study, at weeks 4 and 8. and at follow-up 4 months after the study. A blood sample was drawn before and after the 8-week intervention to measure the concentrations of serum lipids. RESULTS: Ninety-eight subjects completed the 8-week study. Both exercise and bright light effectively relieved depressive symptoms. Bright light reduced atypical depressive symptoms more than exercise (p = .03), based on the atypical symptoms subscore of the Structured Interview Guide for the Hamilton Depression Rating Scale-Seasonal Affective Disorders Version Self-Rating Format. There were no significant differences between the study groups in the changes in serum lipid levels. CONCLUSION: Bright light administered twice a week, alone or combined with physical exercise, seems to be a useful intervention for relieving seasonal mood slumps.     

Interleukin-1B genotype modulates the improvement of coronary artery reactivity by lipid-lowering therapy with pravastatin: a placebo-controlled positron emission tomography study in young healthy men

A polymorphism at position -511 of interleukin-1B (IL-1B) gene promoter regulates IL-1B levels, immune and inflammatory responses and possible atherogenesis. We used positron emission tomography (PET) to study whether coronary reactivity or its response to pravastatin is related to this IL-1B polymorphism. The study comprised a randomized, double-blind, placebo-controlled trial with two treatment groups: (i) pravastatin (40 mg/day, n=14) and (ii) placebo (n=20) for 6 months (baseline mean cholesterol 5.5 +/- 0.8 mmol/l; age 35 +/- 4 years). Myocardial blood flow was measured by PET at rest and during adenosine infusion using 15O-labelled water. PET studies, lipid, IL-1beta and C-reactive protein analyses were performed at baseline and after 6 months of therapy. IL-1B genotype was determined by polymerase chain reaction. There were no differences between IL-1B allele 2 carriers (A2+) and non-carriers (A2-) in basal or adenosine-stimulated myocardial flow (ASMF), at baseline. Regarding the change in ASMF and coronary flow reserve, there was a significant IL-1B genotype-by-treatment group interaction (analysis of covariance, P=0.028 and P=0.002, respectively) during follow-up. In the pravastatin group, the ASMF increased by 18.0% in subjects with IL-1B A2- (n=7), but decreased by 2% in subjects with IL-1B A2+ (n=7). There were no significant changes from the baseline values in placebo recipients. After treatment, both genotype groups showed a similar decrease in serum total and low density lipoprotein cholesterol (P<0.0001 for both). In conclusion, coronary function improves after 6 months of pravastatin therapy in subjects with the IL-1B A2- allele but not in those with the IL-1B A2+ allele.     

Impact of sphincter lesions and delayed sphincter repair on sacral neuromodulation treatment outcomes for faecal incontinence: results from a Finnish national cohort study

Purpose

The aim of this multicentre study was to analyse the effects of patent sphincter lesions and previous sphincter repair on the results of sacral neuromodulation (SNM) treatment on patients with faecal incontinence (FI).

Methods

Patients examined by endoanal ultrasound (EAUS) with FI as the indication for SNM treatment were included in the study. Data was collected from all the centres providing SNM treatment in Finland and analysed for differences in treatment outcomes.

Results

A total of 237 patients treated for incontinence with SNM had been examined by EAUS. Of these patients, 33 had a history of previous delayed sphincter repair. A patent sphincter lesion was detected by EAUS in 128 patients. The EAUS finding did not influence the SNM test phase outcome (p?=?0.129) or the final treatment outcome (p?=?0.233). Patient’s history of prior sphincter repair did not have a significant effect on the SNM test (p?=?0.425) or final treatment outcome (p?=?0.442).

Conclusions

Results of our study indicate that a sphincter lesion or previous sphincter repair has no significant effect on the outcome of SNM treatment. Our data suggests that delayed sphincter repair prior to SNM treatment initiation for FI is not necessary.

     

Diflunisal in the treatment of low back pain in a multicentre study

An open trial with diflunisal (500 mg twice daily) in 766 outpatients consulting their doctor for low back pain, was carried out as part of the project "Back Pain 1981" in Finland. Of the patients (mean age 41 years), 460 had acute lumbago, 144 sciatica and 162 had chronic low back pain as a clinical diagnosis. In each diagnostic group there was a control group of patients receiving no drug therapy. Of the patients 65 percent were men and 35 percent women and the groups did not differ from this distribution in any diagnosis. The efficacy of the treatment was evaluated using four criteria: change of pain at rest and during exercise, patient's evaluation of the efficacy of the treatment, and the need for any supportive treatment. Side-effects of the drug therapy were registered. In all diagnostic groups the relief of pain both at rest and during exercise was greater in patients receiving diflunisal than in the controls. The greatest difference was found in lumbago. The patient's evaluation did not differ between the groups. The drug therapy diminished the need for supportive physical therapy. The frequency of side-effects was 8.6%. They led to the discontinuation of medication in 14 cases (3%). No severe side-effects were found. Diflunisal therapy for the relief of low back pain is therefore considered to be indicated in outpatient care.     

Simultaneous development of cells with large granular lymphocyte (LGL) morphology and natural killer (NK) cell lytic activity after bone marrow (BM) transplantation in mice.

In the present study we investigated the development of natural killer (NK) cell lytic activity, and its correlation with the appearance of cells with large granular lymphocyte (LGL) morphology after bone marrow transplantation (BMT). NK activity was first found 7 days after bone marrow (BM) reconstitution, simultaneously with the appearance of the first LGLs. The number of LGLs, as well as the lytic activity, increased until Day 16 after BM reconstitution, after which they started to decrease, reaching the normal values of controls in 30 days. These early appearing LGLs differed somewhat from mature-type LGLs; they were larger, blast-like cells (found in the lower density fractions of Percoll gradient) and had a basophilic cytoplasma, in contrast to a pale cytoplasm in mature LGLs, but they expressed the asialo GM 1 (AGM 1) antigen like normal NK cells. Those NK cells that appeared first also tended to be lytically more effective than their mature counterparts. Taken together, these data suggest that the correlation between LGL morphology and NK lytic activity also holds true during the development of NK cells from their non-lytic precursors in the bone marrow.     

IL-10 gene polymorphism and herpesvirus infections

Genetics has an important role in resistance to various infections and it also may modify the clinical picture of an infectious disease. Here, we briefly review our recent data demonstrating that the polymorphism of the IL-10 gene is associated with resistance to some common herpesviruses and, additionally, that this same gene is involved in the regulation of the severity of the infection and in the reactivation process.     

Epistatic effect of TLR4 and IL4 genes on the risk of asthma in females

BACKGROUND: Many studies have demonstrated a connection between asthma and T-cell cytokine genes, such as genes coding for interleukin-4 (IL4) and IL-13, which are involved in the regulation of the TH1/TH2 balance. The toll-like receptor 4 (TLR4), the principal receptor for bacterial endotoxin, has attracted attention as a potential risk factor for asthma. We examined whether the polymorphisms of the TLR4 (A/G at +896) and IL4 (C/T at -590) showed an epistatic effect on the risk of asthma or atopy. METHODS: Gene polymorphism analyses and skin prick tests were performed on asthmatic and nonasthmatic adult subjects of a Finnish population-based case-control study. The phenotype studied was persistent asthma. RESULTS: The results showed that genotypes of neither the TLR4 SNP at +896 nor IL4 SNP at -590 were separately found to be associated with asthma. However, the female carriers of allele G (i.e. genotype AG or GG) of TLR4 and allele T (genotype CT or TT) of IL4 had a significantly increased risk for asthma. No association of these genes and atopy was found. CONCLUSIONS: Our results indicate that in females the TLR4 and IL4 genes show an epistatic effect on the risk of asthma. The low LPS-responsive allele G of TLR4 and high IgE production allele T of IL4 were found to be the predisposing combination. However, there was no epistatic effect on the risk of atopy.     

Expression of a mouse Ig V gene in antibodies of three immunoglobulin classes

In an earlier study we found that some mouse strains, including the C57BL/6, produced irregular IgG anti-(4-hydroxy-3-nitrophenyl)acetyl (NP) antibodies to protein conjugates of this hapten. This antibody had heteroclitic fine specificity and a characteristic isoelectric focusing pattern. Breeding studies suggested that these qualities of the C57BL/6 anti-NP were controlled by a V gene of the heavy chain. We have now found that this V gene is expressed in anti-NP antibodies and plaque-forming cells of all major immunoglobulin classes: IgG, IgA and IgM.