Effects of a Pre-surgery Supervised Exercise Training 1 Year After Bariatric Surgery: a Randomized Controlled Study

Background

We have previously reported on the benefits of Pre-Surgical Exercise Training (PreSET) on physical fitness and social interactions in subjects awaiting bariatric surgery (BS). However, data are needed to know whether these benefits are maintained post-BS.

Objectives

The purpose of this paper was to evaluate the effect of PreSET on physical activity (PA) level, physical fitness, PA barriers, and quality of life (QoL) 1 year (1-Y) after BS.

Methods

Of the 30 participants randomized into two groups (PreSET and usual care), 25 were included in the final analysis. One year after BS, time spent in different PA intensities and number of steps were assessed with an accelerometer. Before BS and until 1-Y after BS, physical fitness was assessed with symptom-limited cardiac exercise test, 6-min walk test (6MWT), and sit-to-stand, half-squat, and arm curl tests. QoL, PA barriers, and PA level were evaluated with questionnaires.

Results

The number of steps (7460 vs 4287) and time spent in light (3.2 vs 2.2 h/day) and moderate (0.6 vs 0.3 h/day) PA were higher in the PreSET group 1-Y after BS. The changes in 6MWT heart cost (1.3 vs 0.6 m/beats/min), half-squat test (38.8 vs 10.3 s), and BMI (? 16.8 vs ? 13.5 kg/m²) were significantly greater in the PreSET group compared to those in the usual care group. No other significant difference between groups was observed.

Conclusion

The addition of the PreSET to individual lifestyle counseling seems effective to improve PA level and submaximal physical fitness 1-Y after BS. Studies with larger cohorts are now required to confirm these results.The trial was registered at clinicaltrials.gov (NCT01452230).

     

Review article: the clinical relevance of transient lower oesophageal sphincter relaxations in gastro-oesophageal reflux disease

Aliment Pharmacol Ther 2011; 33: 650–661

Summary

Background Transient lower oesophageal sphincter relaxations (TLOSR) are considered the physiological mechanism that enables venting of gas from the stomach and appear as sphincter relaxations that are not induced by swallowing. It has become increasingly clear that most reflux episodes occur during TLOSRs and therefore play a key role in gastro‐oesophageal reflux disease (GERD). Aim To describe the current knowledge about TLOSRs and its clinical implications. Methods Search of the literature published in English using the PubMed database and relevant abstracts presented at international conventions. Results Several factors influence the rate of TLOSRs including anti‐reflux surgery, meal, body position, nutrition, lifestyle and a wide array of neurotransmitters. Ongoing insights in the neurotransmitters responsible for the modulation of TLOSRs, as well as the neural pathways involved in TLOSR induction, have lead to novel therapeutic targets. These therapeutic targets can serve as an add‐on therapy in patients with an unsatisfactory response to proton pump inhibitor by inhibiting TLOSRs and its associated reflux events. However, the TLOSR‐inhibiting drugs that are currently available still have significant side effects. Conclusion It is likely that in the future, selected GERD patients may benefit from transient lower oesophageal sphincter relaxation inhibition when compounds are found without significant side effects.     

Case of Mycobacterium marinum infection with unusual patterns of susceptibility to commonly used antibiotics

Mycobacterium marinum, found commonly in salt water and freshwater, is the causative agent of disease in many species of fish and occasionally in humans. MICs to most antimicrobial agents are relatively low. Susceptibility testing is not routinely performed, and single-drug therapy is used for the treatment of most infections. Here, we report an infection caused by a drug-resistant M. marinum strain in an otherwise healthy patient.     

Effect of antioxidants combined to resistance training on BMD in elderly women: a pilot study

Summary  We determined the effect of antioxidants and resistance training on bone mineral density of postmenopausal women. After 6 months, we observed a significant decrease in the lumbar spine BMD of the placebo group while other groups remained stable. Antioxidants may offer protection against bone loss such as resistance training. Introduction  The purpose of this pilot study was to determine the effects of antioxidant supplements combined to resistance training on bone mineral density (BMD) in healthy elderly women. Methods  Thirty-four postmenopausal women (66.1 ± 3.3 years) were randomized in four groups (placebo, n = 7; antioxidants, n = 8; exercise and placebo, n = 11; and exercise and antioxidants, n = 8). The 6-month intervention consisted in antioxidant supplements (600 mg vitamin E and 1,000 mg vitamin C daily) or resistance exercise (3×/week). Femoral neck and lumbar spine BMD (DXA) and dietary intakes (3-day food record) were measured before and after the intervention. A repeated measure ANOVA and non-parametric Mann–Whitney U tests were used. Results  We observed a significant decrease in the placebo group for lumbar spine BMD (pre, 1.01 ± 0.17 g/cm²; post, 1.00 ± 0.16 g/cm²; P < 0.05 respectively) while it remained stable in all other groups. No changes were observed for femoral neck BMD. Conclusions  Antioxidant vitamins may offer some protection against bone loss in the same extent as resistance exercise although combining both does not seem to produce additional effects. Our results suggest to further investigate the impact of antioxidant supplements on the prevention of osteoporosis.     

Increased rate of treatment with antidepressants in patients with epilepsy

The risk of depressive and anxiety disorders is increased among patients with epilepsy, but it is not known whether patients are treated with antidepressants in clinical practice. In a nationwide case register linkage study, all patients who received a main diagnosis of epilepsy or osteoarthritis on first admission or outpatient contact during the period 1995 to 2000 in Denmark were identified, and rates of subsequent purchases of antidepressants were calculated. Comparisons were also made with a gender-, age-, and calendar-matched sample of the general population. Patients diagnosed with epilepsy had a 1.73 (95% CI: 1.45-2.06) times increased rate of subsequently purchasing antidepressants, compared with patients diagnosed with osteoarthritis and a 2.44 times (95% CI: 2.12-2.81) increased rate compared with the rate among the general population. It is concluded that patients with epilepsy have a moderately increased probability of being prescribed antidepressants in clinical practice.     

Do stressful life events predict medical treatment outcome in first episode of depression?

Background  

It is unclear whether medical treatment outcome in first episode depression differ for patients with and without stressful life events prior to onset of depression.