A randomized study to evaluate the effect of exercise on fatigue in people with relapsing-remitting multiple sclerosis treated with fingolimod.

BACKGROUND: Fatigue is a major symptom of multiple sclerosis (MS) in patients, and it has been shown to improve with physical exercise. Although fingolimod might lessen fatigue, it is unclear how patients treated with fingolimod react to physical activity regarding fatigue. OBJECTIVE: This study evaluated the effect of an exercise intervention on fatigue in relapsing-remitting MS patients receiving fingolimod. METHODS: People with MS (PwMS) were randomized to either a structured internet-based exercise program (e-training) or no e-training intervention. The primary endpoint was the change in the Modified Fatigue Impact Scale (mFIS) after six months. RESULTS: The primary analysis showed no statistically significant difference between groups in the mFIS change. Subgroup analyses revealed a beneficial effect of physical exercise for PwMS with low aerobic capacity and with low aerobic capacity plus more severe fatigue. The incidence of adverse events was similar in both groups. No cardiovascular events were reported. The majority of PwMS were relapse free. CONCLUSION: Physical exercise benefits on fatigue may depend on the physical capacity of the patient and requires individualized training. Consistent with previous studies, these results suggest that physical exercise generally does not impose a risk and that this holds true also for patients receiving fingolimod.Trial registration: ClinicalTrials.gov, NCT01490840.

Proactive personality and career success.

This study examined the relationship between proactive personality and career success by surveying a sample of 496 employees (320 men and 176 women) from a diverse set of occupations and organizations. Proactive personality was positively associated with both self-reported objective (salary and promotions) and subjective (career satisfaction) indicators of career success. Hierarchical regression analyses showed that proactive personality explained additional variance in both objective and subjective career success even after controlling for several relevant variables (demographic, human capital, motivational, organizational, and industry) that have previously been found to be predictive of career outcomes. These findings were consistent using both self-report and significant--other ratings of proactive personality.

Natural selection on the gag, pol, and env genes of human immunodeficiency virus 1 (HIV-1).

Natural selection on polymorphic protein-coding loci of human immunodeficiency virus-1 (HIV-1), the more geographically widespread of the two viruses causing human acquired immune deficiency syndrome (AIDS), was studied by estimating the rates of nucleotide substitution per site in comparisons among alleles classified in families of related alleles on the basis of a phylogenetic analysis. In the case of gag, pol, and gp41, the rate of synonymous substitution generally exceeded that of nonsynonymous substitution, indicating that these genes are subject to purifying selection. However, in the case of several of the variable (V) regions of the gp120 gene, especially V2 and V3, comparisons within and between families often showed a significantly higher rate of nonsynonymous than of synonymous nucleotide substitution. This pattern of nucleotide substitution indicates that positive Darwinian selection has acted to diversify these regions at the amino acid level. The V regions have been identified as probable epitopes for antibody recognition; therefore, avoidance of such recognition seems likely to be the basis for positive selection on these regions. By contrast, regions of HIV-1 proteins identified as epitopes for T cell recognition show no evidence of positive selection and are often highly conserved at the amino acid level. These results suggest that selection favoring avoidance of T cell recognition has not been a major factor in the history of HIV-1 and thus that avoidance of T cell recognition is not likely to be a major factor in the pathogenesis of AIDS.

Iatrogenic brachymetatarsia.

The authors present a case report of iatrogenic brachymetatarsia. The literature was reviewed and various surgical treatments discussed. The metatarsal was lengthened using a sagittally placed Z lengthening step-up osteotomy, with an autogenous bone graft and rigid internal fixation.

Characterization of osteoblast-like cells from fetal rat calvaria.

An improved method is described for the isolation of osteoblast-like cells from fetal rat calvaria. The cells are mononuclear, 8.3 mu in diameter, alkaline phosphate positive, and possess rough endoplasmic reticulum, mitochondria, Golgi, and cytoplasmic processes. Isolated bone cells synthesize collagen and cholesterol, grow to confluence in primary culture, and respond to hormonal stimulation.

Cerebral asymmetry: changes in factors affecting its development.

The present study offered further support for the notion that hemispheric differences are present during early infancy. Moreover, in addition to finding evidences are present during early infancy. Moreover, in addition to finding evidence of electrophysiological differences between male and female infants, discrete components of the AEP response were identified and isolated that were responsive to specific aspects of the acoustic stimuli. Information concerning temporal differences in the processing of these elements was also obtained.

Prescription data processing--its role in the control of drug abuse.

Prescriptions in an outpatient setting were kept on file for immediate recall by computer terminals. Drugs with abuse potential were found to make up 33.6 percent of all prescriptions, and 12.4 percent of these prescriptions were for excessive quantities. An additional 2.6 percent of these prescriptions represented irrationally large quantities of drugs dispensed by multiple prescriptions. The physician was cooperative and willing to correct this situation when it was brought to his attention by the pharmacist.