Little is known about whether acute exercise affects signs or symptoms of attention deficit/hyperactivity disorder (ADHD) in adults. This experiment sought to determine the effects of a single bout ...of moderate-intensity leg cycling exercise on measures of attention, hyperactivity, mood, and motivation to complete mental work in adult men reporting elevated ADHD symptoms.
A repeated-measures crossover experiment was conducted with 32 adult men (18-33 yr) with symptoms consistent with adult ADHD assessed by the Adult Self-Report Scale V1.1. Measures of attention (continuous performance task and Bakan vigilance task), motivation to perform the mental work (visual analog scale), lower leg physical activity (accelerometry), and mood (Profile of Mood States and Addiction Research Center Inventory amphetamine scale) were measured before and twice after a 20-min seated rest control or exercise condition involving cycling at 65% V˙O2peak. Condition (exercise vs rest) × time (baseline, post 1, and post 2) ANOVA was used to test the hypothesized exercise-induced improvements in all outcomes.
Statistically significant condition-time interactions were observed for vigor (P < 0.001), amphetamine (P < 0.001), motivation (P = 0.027), and Profile of Mood States depression (P = 0.027), fatigue (P = 0.030), and confusion (P = 0.046) scales. No significant interaction effects were observed for leg hyperactivity, simple reaction time, or vigilance task performance (accuracy, errors, or reaction time).
In young men reporting elevated symptoms of ADHD, a 20-min bout of moderate-intensity cycle exercise transiently enhances motivation for cognitive tasks, increases feelings of energy, and reduces feelings of confusion, fatigue, and depression, but this has no effect on the behavioral measures of attention or hyperactivity used.
Regular physical activity contributes positively to physical and psychological health. Adverse consequences of inactivity may be an especially important problem among pregnant women. Up to 60% are ...inactive during pregnancy. This review found consistent evidence that physical activity is reduced during pregnancy; however, few investigators have sought to quantify physical activity patterns among pregnant women using well validated measures. Some of the barriers to physical activity during pregnancy, such as depression, anxiety and fatigue, have been shown to be attenuated by regular exercise performed by non-pregnant samples. There is a need to better understand the relationships between these factors and physical activity during pregnancy. Available retrospective and prospective results suggest that both leisure time and work-related physical activities are decreased across pregnancy. Intensity and duration decrease both during pregnancy compared with pre-pregnancy and in the third trimester compared with the first. There is a need for well designed longitudinal investigations that document pregnancy-related changes in physical activity at frequent intervals during pregnancy using validated and more precise measures of physical activity. Reductions in physical activity and a worsening mood are common during pregnancy. If the relationship between physical inactivity and mood disturbances is indeed observed and maintained during pregnancy, then decreases in physical activity in the third trimester would be expected to result in a worsening mood. In recent years, increased attention has been paid to antenatal mood disturbances, and this research has yielded a host of important findings. Prior correlational and experimental research with non-pregnant samples has demonstrated a consistent relationship between physical inactivity and mood disturbances. Whether this relationship occurs among pregnant women and/or is maintained as women progress during pregnancy is uncertain. Prior investigations have revealed that there is higher rate of mood disturbance during pregnancy than following pregnancy but little is known about the mechanisms that cause these mood disturbances. It is important to better understand changes in mood with pregnancy because mood disturbances can have major negative consequences for a pregnant woman. The major adverse consequences of depression among pregnant women are largely the same as those of non-pregnant individuals. Only six investigations have quantified the relationship between changes in physical activity and changes in mood during pregnancy. The available evidence suggests that inactivity is associated with worse mood. Additional research into this topic is warranted due to the limited number of published papers and the design and methodology limitations of these investigations.
This brief review summarizes key epidemiological and experimental evidence concerning relationships between chronic physical activity and feelings of energy (vigor, vitality) and fatigue. The ...epidemiological studies show a positive association between the amount of typical weekly physical activity reported and the frequency with which people report feeling energetic. The randomized controlled experiments show that 10-20 wk of exercise training is associated with an increase in the frequency and intensity of feelings of energy among fatigued people with medical conditions. The results of longitudinal studies with non-fatigued, healthy adults are mixed. Overtraining by athletes is associated with increased intensity of feelings of fatigue. Additional well-controlled investigations into relationships between physical activity and feelings of energy and fatigue, especially among sedentary and fatigued individuals, are warranted given the available evidence and the importance of these moods to health, work productivity, and quality of life.
Despite the molecular and histological similarities between fetal bone development and fracture healing, inflammation is an early phase of fracture healing that does not occur during development. ...Cyclo‐oxygenase 2 (COX‐2) is induced at inflammation sites and produces proinflammatory prostaglandins. To determine if COX‐2 functions in fracture healing, rats were treated with COX‐2‐selective nonsteroidal anti‐inflammatory drugs (NSAIDs) to stop COX‐2‐dependent prostaglandin production. Radiographic, histological, and mechanical testing determined that fracture healing failed in rats treated with COX‐2‐selective NSAIDs (celecoxib and rofecoxib). Normal fracture healing also failed in mice homozygous for a null mutation in the COX‐2 gene. This shows that COX‐2 activity is necessary for normal fracture healing and confirms that the effects of COX‐2‐selective NSAIDs on fracture healing is caused by inhibition of COX‐2 activity and not from a drug side effect. Histological observations suggest that COX‐2 is required for normal endochondral ossification during fracture healing. Because mice lacking Cox2 form normal skeletons, our observations indicate that fetal bone development and fracture healing are different and that COX‐2 function is specifically essential for fracture healing.
This paper evaluates four highly cited measures of energy and fatigue moods. Substantial experimental and correlational evidence supports the conclusion that scores from the vitality scale of the ...SF-36 Health Survey can provide a valid measure of the recalled frequency of month-long feelings of energy and fatigue. Substantial experimental and correlational evidence supports the conclusion that scores from the fatigue and vigor scales of the Profile of Mood States (POMS) can provide reliable and valid measures the intensity of both week-long and “right now” fatigue and energy mood states, respectively. A smaller body of evidence supports the conclusion that scores from the energy scale of the Activation–Deactivation Adjective Checklist (AD-ACL) can provide a valid measure of the “right now” mood of energy; however, the energy scale of the AD-ACL has several limitations compared to the POMS vigor scale. All the measures lacked integration within a compelling theory of the mood of energy–fatigue. It is concluded that progress in understanding of energy and fatigue mood states will be aided by advances in both the psychobiological conceptualization of fatigue and energy mood states and their measurement.
Summary Although all weight-loss approaches may improve insulin sensitivity in type 2 diabetes, bariatric surgery is believed to be the only reliable means of achieving diabetes remission. We ...conducted a retrospective cohort study to compare rates of diabetes remission, relapse and all-cause mortality among severely obese individuals with diabetes who underwent bariatric surgery vs. nonsurgically treated individuals. Severely obese adults with uncontrolled or medication-controlled diabetes who underwent bariatric surgery or received usual medical care from 2005 to 2008 in three health care delivery systems in the United States were eligible. Diabetes status was identified using pharmacy, laboratory, and diagnosis information from electronic medical records. A propensity approach and exclusion criteria identified 1395 adults with diabetes who had bariatric surgery and 62,322 who did not. Most procedures were Roux-en-Y gastric bypass (72.0% laparoscopic; 8.2% open); 4.4% were gastric banding, 2.4% sleeve gastrectomy, and 13.2% were other procedures. At two years, bariatric subjects experienced significantly higher diabetes remission rates 73.7% (95% CI: 70.6, 76.5) compared to nonsurgical subjects 6.9% (95%CI: 6.9, 7.1). Age, site, duration of diabetes, hemoglobin A1c level, and intensity of diabetes medication treatment were significantly associated with remission. Bariatric subjects also experienced lower relapse rates than nonsurgical subjects (adjusted HR: 0.19; 95% CI: 0.15–0.23) with no higher risk of death (adjusted HR: 0.54; 95% CI: 0.22–1.30). We conclude that bariatric surgery can effectively induce remission of diabetes among most severely obese adults, and this treatment approach appears to be superior to nonsurgical treatment in inducing diabetes remission.
This study compared the acute treatment effects of systemic analgesics with (celecoxib) and without anti-inflammatory activity (acetaminophen) on bone fracture healing.
Longitudinal time study of ...fracture healing in rats.
Closed, mid diaphyseal femur fractures were produced in female Sprague-Dawley rats. The rats were treated for 10 days after fracture with 60 or 300 mg/kg of acetaminophen, 3 or 6 mg/kg of celecoxib, or vehicle by once-daily oral dosing. Fracture healing was measured after 8 weeks by radiographic examination, mechanical testing, and histology.
Radiographic scoring indicated that acute celecoxib treatment significantly impaired fracture healing; acetaminophen treatment had no negative effect. Mechanical testing supported the radiographic observations. No negative effects of celecoxib or acetaminophen treatment on the structural properties (peak torque and torsional rigidity) of the healing femurs were detected. In contrast, celecoxib treatment, but not acetaminophen treatment, significantly reduced the material properties (maximum shear stress and shear modulus) of the healing femurs (P < 0.001). Post-mechanical testing examination of the healing femurs found that 73% of the vehicle-treated or acetaminophen-treated femurs had healed as unions (30/41), 27% failed as incomplete unions (11/41), and none failed as nonunions (0%). In contrast, only 21% of the fractured femurs from the celecoxib treated rats had healed as unions (7/34), 53% failed as incomplete unions (18/34), and 26% failed as nonunions (9/34). The proportion of nonunions among the celecoxib-treated rats was significantly higher compared with the control and acetaminophen-treated rats (P < 0.001). Histologic examination indicated that similar to previous studies, celecoxib treatment, but not acetaminophen treatment, altered normal fracture callus morphology in which cartilage rather than new bone abuts the fracture site.
No negative effect from acute acetaminophen treatment on fracture healing was detected. In contrast, acute treatment with celecoxib, a selective cyclooxygenase-2 inhibitor with anti-inflammatory activity, significantly impaired fracture healing.
To understand the burden of medication use for patients with newly diagnosed diabetes both before and after diabetes diagnosis and to identify subpopulations of patients with newly diagnosed diabetes ...who face a relatively high drug burden.
Retrospective cohort study.
11 integrated health systems in the United States.
196,654 insured adults 20 years of age or older newly diagnosed with type 1 or type 2 diabetes from January 2005 through December 2009.
Number of unique therapeutic classes of drugs dispensed in the 12 months before and 12 months after diagnosis of diabetes in five categories: overall, antihypertensive agents, antihyperlipidemic agents, mental health agents, and antihyperglycemic agents (in the postdiagnosis period only).
The mean number of drug classes used by newly diagnosed patients with diabetes is high before diagnosis (5.0) and increases significantly afterward (6.6). Of this increase, 81% is due to antihyperglycemic initiation and increased use of medications to control hypertension and lipid levels. Multivariate analyses showed that overall drug burden after diabetes diagnosis was higher in women, older, white, and obese patients, as well as among those with higher glycosylated hemoglobin concentrations and comorbidity levels (significant for all comparisons). The overall number of drug classes used by newly diagnosed patients with diabetes after diagnosis decreased slightly but significantly between 2005 and 2009.
Patients newly diagnosed with diabetes face a substantially increased burden of medications used to control diabetes and other comorbidities. This study shows an increased focus on cardiovascular disease risk factor control after diagnosis of diabetes. However, total drug burden may be slightly decreasing over time.
Traditional and COX-2 selective non-steroidal anti-inflammatory drug (NSAID) treatment inhibits fracture healing in animal models. This indicates that either the inflammatory phase following a bone ...fracture is necessary for efficient or sufficient bone regeneration to heal the fracture or COX-2 may have a specific function during bone regeneration unrelated to inflammation. These observations also indicate that NSAID use during fracture healing may be contra-indicated. Thus, identification of different analgesics for fracture pain or other orthopaedic surgical procedures would be of significant clinical benefit. Inhibitors of p38 kinase also have significant analgesic properties. However, p38 kinase is a critical regulator of inflammation. To assess the potential use of p38 kinase inhibition as a therapeutic strategy to manage fracture pain, the analgesic properties of SCIO-469, a p38alpha kinase inhibitor, were assessed in a rat fracture model and compared to other common analgesics. In addition, the effects of SCIO-469 treatment on ultimate fracture healing outcomes were measured by radiography and torsional mechanical testing. The data indicate that SCIO-469 was an effective analgesic. No adverse events related to fracture healing were observed in rats treated with SCIO-469. Immunohistochemistry showed that p38 kinase is activated primarily in the first days following a fracture. These observations suggest that p38alpha kinase inhibition may be an effective therapeutic strategy to manage orthopaedic-related pain. These observations also indicate that COX-2 has a specific function during bone regeneration other than promoting inflammation.
A key challenge to optimising marathon running performance is to train with adequate frequency, duration and intensity as well as get enough recovery to optimise biological adaptations underlying ...performance. Some marathon runners train inadequately and underperform, while others perform poorly because they become injured or develop staleness in response to overtraining. Staleness, a depression-like syndrome, could plausibly be caused by overtraining-induced molecular and cellular changes in brain circuits involved in depression or other related mood states such as anger, fatigue, vigor and confusion. The central thesis of this paper is that easily assessed resting and/or exercise symptoms, valid markers of either difficult-to-access, expensive-to-assess or unmeasurable brain circuits, can be used to optimise marathon running performance by helping to avoid either inadequate training or excessive training resulting in staleness. Available models of human performance and relevant data, admittedly incomplete at the present time, suggest that marathon runners may benefit from systematically using symptom responses to training in order to aid in adjusting training loads for the purpose of optimising training. As this approach is better linked with neuroscience and neuroimaging findings, it could be refined and prove to be useful for elite as well as non-elite marathon runners.
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