Efficacy of ultraviolet B radiation versus vitamin D3 on postural control and cognitive functions in relapsing-remitting multiple sclerosis: A randomized controlled study

BACKGROUND

The relapsing-remitting multiple sclerosis (RRMS) is the most common type of MS with prevalence rate 20-60 patients/100.000 individuals in Egypt. Poor postural control and cognitive dysfunctions are well-established complications of RRMS without potent remedy yet. The latest evidence highlighted the potential and independent immune-modulating effects of vitamin D3 and ultraviolet radiation in the management of RRMS.

OBJECTIVE

To investigate the efficacy of broadband ultraviolet B radiation (UVBR) versus moderate loading dose of vitamin D3 supplementation in improving postural control and cognitive functions.

DESIGN

Pretest-posttest randomized controlled study.

SETTING

Multiple sclerosis outpatient unit of Kasr Al-Ainy Hospital.

PARTICIPANTS

Forty-seven patients with RRMS were recruited from both genders, yet only 40 completed the study.

INTERVENTIONS

Patients were randomized into two groups: UVBR group involved 24 patients, received sessions for 4 weeks and vitamin D3 group involved 23 patients, took vitamin D3 supplementation (50 000 IU/week) for 12 weeks.

MAIN OUTCOME MEASURES

Overall balance system index (OSI) and symbol digit modalities test (SDMT).

RESULTS

Highly significant decrease (P < 0.001) of the OSI in both groups post-treatment, indicating improved postural control. Moreover, highly significant improvement in the SDMT scores was noted, indicating information processing speed enhancement. Nonetheless, no statistically significant (P ≥ 0.05) differences were evident between the two groups post-treatment in all tested measures.

CONCLUSION

Both therapeutic programs were statistically equal in improving postural control and cognitive functions. However, clinically, UVBR therapy was more convenient owing to its shorter treatment time and higher percentage of change for all tested measures.

Effects of Exercise Mode on Improving Cardiovascular Function and Cardiorespiratory Fitness After Bariatric Surgery: A Narrative Review

ABSTRACT

Obesity affects 600 million people globally and increases the risk of developing cardiovascular disease, stroke, diabetes, and cancer. Bariatric surgery is an increasingly popular therapeutic intervention for morbid obesity to induce rapid weight loss and reduce obesity-related comorbidities. However, some bariatric surgery patients, after what is considered a successful surgical procedure, continue to manifest obesity-related health issues, including weight gain, reduced physical function, persistent elevations in blood pressure, and reduced cardiorespiratory fitness. Cardiorespiratory fitness is a strong predictor of mortality and several health outcomes and could be improved by an appropriate exercise prescription after bariatric surgery. This review provides a broad overview of exercise training for patients after bariatric surgery and discusses cardiorespiratory fitness and other potential physiological adaptations in response to exercise training.

Anti-proliferative, Anti-angiogenic and Anti-inflammatory Effects of Moringa peregrina Leaf Extracts on Testosterone- Induced Benign Prostatic Hyperplasia in Rats

AIM

To investigate the potential anti-inflammatory and biochemical effects of Moringa peregrina leaf extracts on testosterone-induced benign prostatic hyperplasia (BPH) in rats.

METHODS

Six groups of rats (each group included 5 rats) were included in this study. The groups included: 1) the control group, 2) the testosterone-induced BPH group, 3) with 50 mg/kg bwt (bodyweight) oil-treated BPH, 4) with 100 mg/kg bwt. oil-treated BPH, 5) with 500mg/kg bwt. ethanol treated BPH and 6) with 1,000 mg/kg bwt. aqueous treated BPH group. Biochemical markers were measured to evaluate the effect of M. peregrina leaf extracts.

RESULTS

Our results showed a significant improvement in the thickness of epithelial cells of the BPH glandular tissues when treated with different M. peregrina extracts (p < 0.05). In addition, M. peregrina extracts showed anti-inflammatory, anti-proliferative and anti-angiogenesis effects on the BPH tissues by reduction of IL-6, PCNA and VEGF-A, respectively.

CONCLUSION

Our preclinical study concluded that M. peregrina leaf extracts showed a significant effect on BPH by reducing inflammation, proliferation, and angiogenic processes with no signs of toxicity.

More than a matter of the heart: the concept of intravascular multimorbidity in cardiac rehabilitation

INTRODUCTION

Coronary artery disease (CAD) is the major cause of death of cardiovascular disease. It is initiated by atherosclerosis, which narrows the coronary arteries and limits blood flow and oxygen to the heart. Multiple pathophysiological conditions within the arteries, such as arterial wall thickening, endothelial dysfunction, and arterial stiffening, are associated with the development of atherosclerosis.

AREAS COVERED

We introduce a new concept of 'intravascular multimorbidity,' the presence and integration of multiple pathophysiological conditions within the arteries. We also introduce some measurements of intravascular multimorbidity and discuss how these measurements can be utilized in cardiac rehabilitation (CR).

EXPERT OPINION

We propose that the measures of intravascular multimorbidity in different arteries may provide information on disease severity and serve as unique prognostic 'barometers' to disease progression in patients with CAD. By measuring the underlying disease mechanisms within the arteries and understanding individual variability of disease progression/regression, these measures may also provide a unique prognostic window in CR. The window into intravascular multimorbidity can help guide clinical strategies, for example, assessing progress and appropriate titration of exercise. Intravascular multimorbidity may represent an important opportunity for more researchers and clinical professions to evaluate patients in CR.

Precision Measurements to Assess Baseline Status and Efficacy of Healthy Living Medicine

Precision medicine recently has gained popularity, calling for more individualized approaches to prevent and/or reduce chronic-disease risk and to reduce non-communicable diseases such as cardiovascular disease (CVD). Encompassed under Precision medicine initiatives is the concept of healthy living medicine (HLM), which emphasizes the promotion of lifestyle and behavioral practices including physical activity and healthy dietary pattern. Precision measurements have the potential to improve the understanding of how risk factors influence disease trajectory, and further inform on how to precisely tailor clinical strategies to manage risk factors to prevent disease manifestation, and refine therapies according the patient's demographic, environment, and disease etiology. The purpose of this review is to summarize the application of established and emerging measurements that may be used in HLM to manage and optimize care in CVD prevention.

Advances in Health Technology Use and Implementation in the Era of Healthy Living: Implications for Precision Medicine

Much of the focus of precision medicine has been directed toward genomics, despite the fact that "lifestyle and behavioral factors" are included in the description of precision medicine. Numerous structured diet and PA interventions have demonstrated success in preventing and/or reducing chronic-disease risk. The use of personal health technologies has expanded exponentially in the health care arena; there are a number of consumer-based technologies yielding health information to individual users. The explosion in technology use provides an opportunity for broader dissemination of health care services and products. In addition, tracking cardiovascular disease risk and lifestyle and behavioral aspects of healthy living (HL) profiles in those products may be an important leveraging interface for precision medicine. This review will discuss and present an overview of current health technologies, their use in promotion of HL metrics and how this data may be integrated into venues that support HL and precision medicine.

Use of virtual reality gaming systems for children who are critically ill

Children who are critically ill are frequently viewed as "too sick" to tolerate physical activity. As a result, these children often fail to develop strength or cardiovascular endurance as compared to typically developing children. Previous reports have shown that early participation in physical activity in is safe and feasible for patients who are critically ill and may result in a shorter length of stay and improved functional outcomes. The use of the virtual reality gaming systems has become a popular form of therapy for children with disabilities and has been supported by a growing body of evidence substantiating its effectiveness with this population. The use of the virtual reality gaming systems in pediatric rehabilitation provides the children with opportunity to participate in an exercise program that is fun, enjoyable, playful, and at the same time beneficial. The integration of those systems in rehabilitation of children who are critically ill is appealing and has the potential to offer the possibility of enhancing physical activities. The lack of training studies involving children who are critically ill makes it difficult to set guidelines on the recommended physical activities and virtual reality gaming systems that is needed to confer health benefits. Several considerations should be taken into account before recommended virtual reality gaming systems as a training program for children who are critically ill. This article highlighted guidelines, limitations and challenges that need to be considered when designing exercise program using virtual reality gaming systems for critically ill children. This information is helpful given the popular use of virtual reality gaming systems in rehabilitation, particularly in children who are critically ill.

Effects of exercise and B vitamins on homocysteine and glutathione in Parkinson's disease: a randomized trial

BACKGROUND

Individuals with Parkinson's disease (PD) have decreased glutathione levels and elevated homocysteine levels. These substances are considered markers of health, and an inverse relationship has been suggested through the transsulfuration pathway. This experiment tested the effects of exercise and B vitamin supplementation on homocysteine and glutathione levels, and if a relationship was present between these two markers in those with PD. Secondary aims included examining the impact of the interventions on aerobic efficiency and strength.

METHODS

Thirty-six subjects were randomly assigned to 4 groups. The Vit group received vitamins B(6), B(12) and folic acid daily for 6 weeks. The Ex group received aerobic and strength training twice weekly for 6 weeks. The Vit + Ex group received both interventions. A control group received no intervention. Subjects were tested prior to and after intervention on the following measures: glutathione and homocysteine levels, strength measures and oxygen consumption.

RESULTS

Subjects who received 6 weeks of B vitamin supplementation had lowered homocysteine levels. Subjects who received 6 weeks of exercise training had increased glutathione levels, strength and aerobic capacity. The combination of vitamin and exercise did not yield greater changes than the separate intervention. The control subjects did not change on any measures.

CONCLUSION

Positive results were realized with each intervention; however, the expected relationship between glutathione and homocysteine was not found in this sample of subjects with PD. Homocysteine and glutathione levels can be improved independently in individuals with PD with exercise or vitamins B(6), B(12) and folic acid supplementation.