Acute effects of physical activity patterns on plasma cortisol and brain-derived neurotrophic factor in relation to corticospinal excitability.

Brain-derived neurotrophic factor (BDNF) and cortisol are both capable of modulating synaptic plasticity, but it is unknown how physical activity-induced changes in their plasma levels relate to corticospinal plasticity in humans. Sixteen inactive middle-aged men and women participated in three separate interventions consisting of 3 h prolonged sitting (SIT); 3 h sitting interrupted every 30 min with frequent short physical activity breaks (FPA); and 2.5 h prolonged sitting followed by 25 min of moderate intensity exercise (EXE). These 3 h sessions were each followed by a 30 min period of paired associative stimulation over the primary motor cortex (PAS). Blood samples were taken and corticospinal excitability measured at baseline, pre PAS, 5 min and 30 min post PAS. Here we report levels of plasma BDNF and cortisol over three activity conditions and relate these levels to previously published changes in corticospinal excitability of a non-activated thumb muscle. There was no interaction between time and condition in BDNF, but cortisol levels were significantly higher after EXE compared to after SIT and FPA. Higher cortisol levels at pre PAS predicted larger increases in corticospinal excitability from baseline to all subsequent time points in the FPA condition only, while levels of BDNF at pre PAS did not predict such changes in any of the conditions. Neither BDNF nor cortisol modified changes from pre PAS to the subsequent time points, suggesting that the increased corticospinal excitability was not mediated though an augmented effect of the PAS protocol. The relationship between cortisol and plasticity has been suggested to be inverted U-shaped. This is possibly why the moderately high levels of cortisol seen in the FPA condition were positively associated with changes AURC, while the higher cortisol levels seen after EXE were not. A better understanding of the mechanisms for how feasible physical activity breaks affect neuroplasticity can inform the theoretical framework for how work environments and schedules should be designed.

Sick leave due to mental disorders, morbidity and mortality: a prospective study of discordant twin pairs.

PURPOSE: To investigate if sick leave due to mental disorders increases the risk of morbidity measured by inpatient and specialized outpatient care, and mortality among women and men, independent of familial factors. METHODS: An open cohort study of 4979 twin pairs discordant for sick leave due to mental disorders was conducted in 2005-2013. Twins were followed up in the cause of death and national patient registries until the end of study, emigration, death, and inpatient and specialized outpatient care. Conditional Cox proportional hazard regression, adjusting for the familial factors shared by the twins, was used to calculate hazard ratios (HR) with 95% confidence intervals (CI). In case of non-proportional hazards, time-varying covariates were used. RESULTS: Sick leave due to mental disorders increased the risk for inpatient care among men (HR: 1.90, CI 1.66-2.17) and women (HR: 1.39, CI 1.27-1.51). For men, the risk of outpatient care was higher the first 2 years (HR: 2.08, CI 1.87-2.31), after which it was attenuated (HR: 1.32, CI 1.02-1.70). For women, the HR was 1.57 (CI 1.47-1.68) for the whole study time. There was an increased risk of death among men (HR: 2.91, CI 1.70-4.99), but not among women (HR: 0.84, CI 0.53-1.35). CONCLUSIONS: Sick leave due to mental disorders was a risk factor for mortality for men only, and increased the risk of inpatient and specialized outpatient care among both women and men, but the risks were higher for men when stratifying for sex.

[Vomiting after the first trimester of pregnancy: an alarming symptom]. / Braken na het eerste trimester van de zwangerschap: een alarmsymptoom.

Nausea and vomiting are common problems of pregnancy. Three pregnant women, 27, 25 and 28 years of age, presented with vomiting in the third trimester. The causes appeared to be maternal small bowel volvulus, which was derotated after primary caesarean section, an ileocecal abscess, which was the first manifestation of Crohn's disease, and acute pyelonephritis, treated with cefuroxim. The second and third babies were born spontaneously; no maternal or foetal mortality occurred. Persistent vomiting after the first trimester of pregnancy should be considered an alarm symptom which always requires further investigation.

Inversio uteri puerperalis.

Uterine inversion is a rare condition that occurs in various degrees. Predisposing and etiologic factors are discussed, as are therapy and prophylaxis. These points are illustrated by 4 own cases and by 172 cases collected from literature.