The effects of daytime melatonin ingestion on arousal and vigilance vanish after sub-maximal exercise: a pilot study.

OBJECTIVE: Daytime melatonin ingestion is known to induce sleep at rest, which may affect arousal and vigilance. Physical exercise is known to produce an increase in core temperature and circulating cortisol which can enhance arousal and vigilance. The effect of submaximal exercise on vigilance and arousal following acute melatonin ingestion has not yet been studied. The present study aimed at investigating the effect of submaximal exercise on vigilance and arousal following daytime melatonin ingestion. PATIENTS AND METHODS: Eight physical education students undertook 45 min of submaximal exercise (at 60% of maximal aerobic speed) on a treadmill after melatonin-(6 mg) or placebo ingestion, in a randomized and counterbalanced order. RESULTS: Heart rate (HR), rectal temperature (Tre), felt arousal scale (FAS), and thermal sensations (TS) were recorded at baseline (pre-exercise), immediately after exercise (post-exercise), and after 30 min of recovery (30 min post-exercise). Blood was sampled for lactate and cortisol. At 30 min post-exercise, the Tre, HR, blood pressure, lactate, FAS, and TS were measured. The participants performed vigilance tests pre-exercise, post-exercise and 30 min post-exercise. Daytime melatonin ingestion affected arousal and vigilance in the pre-exercise period (p < 0.05) but had no effect on Tre, HR, blood pressure, lactate, TS, arousal, and vigilance measured 30 min post-exercise (p > 0.05). CONCLUSIONS: The negative effects of melatonin ingestion on vigilance and arousal vanished after a 45 min of submaximal exercise. The hypnotic effect of melatonin observed in the pre-exercise dissipated in the post-exercise period, possibly due to the significant elevation of Tre, HR, and cortisol at the end of submaximal exercise.

How physical activity behavior affected well-being, anxiety and sleep quality during COVID-19 restrictions in Iran.

OBJECTIVE: The Islamic Republic of Iran has displayed one of the highest rates of COVID-19 infection in the world and the highest rate of mortality in the Middle East. Iran has used a stringent package of preventive health measures to mitigate the spread of infection, which however has negatively affected individuals' physical and psychological health. This study aimed at examining whether physical-activity (PA) behavior, anxiety, well-being, and sleep-quality changed in response to the COVID-19-related public health restrictions enforced in Iran. PATIENTS AND METHODS: An online questionnaire was disseminated to adults residing in Iran from November 17, 2020, to February 13, 2021 (~88 days), during Iran's strictest public health restrictions. Main outcome measures included Godin-Shephard Leisure-Time Exercise Questionnaire, General Anxiety Disorder-7, Mental Health Continuum-Short Form, and Pittsburgh Sleep Quality Index. RESULTS: A total of 3,323 adults (mean age 30±11 years, 54.3% female) participated in the survey. Firstly, the restrictions generally reduced PA behavior: (a) among inactive participants (IPs), 60.6% became less active vs. 5.1% who became more active; and (b) among active participants (APs), 49.9% became less active vs. 22.8% who became more active. Secondly, PA behavior was associated with higher well-being and sleep quality during the restrictions: (a) APs reported higher (or lower) levels of well-being and sleep quality (or anxiety) than did IPs; and (b) among IPs as well as among APs, the more active the participants, the greater (or lower) the levels of well-being and sleep quality (or anxiety). CONCLUSIONS: This study showed the beneficial role of PA behavior for well-being, anxiety, and sleep quality during the COVID-19 restrictions, whereas such restrictions appeared to decrease PA participation. Active lifestyle should be then encouraged during the COVID-19 outbreak while taking precautions.

[Applicability of the Arabic version of the French quality of life' (QOL) questionnaire (VQ11) in Tunisian patients with chronic obstructive pulmonary disease]. / Évaluation de la version arabe du questionnaire français de qualité de vie « VQ11 ¼ chez des patients tunisiens atteints de bronchopneumopathie chronique obstructive.

BACKGROUND: There is no validated Arabic version of the French questionnaire of quality of life, the VQ11. This study aimed to test the applicability of the Arabic version of the VQ11 in Tunisian patients with chronic obstructive pulmonary disease (COPD). METHODS: It was a prospective and cross-sectional study, spread over seven months, that included 40 stable COPD male patients. The Arabic version of VQ11, translated by a bilingual expert, was used. The functional, psychological, relational and total scores were calculated. Patients were divided into two groups according to the GOLD classification: "A-B" (n=25) and "C-D" (n=15). A significant correlation-coefficient (r) of≥0.51, between the VQ11 total score and the ADO index (age, dyspnoea, obstruction), and higher quality of life scores in GOLD "C-D" when compared to GOLD "A-B" would be in favour of application of the Arabic version of the VQ11. RESULTS: The mean±standard deviation of age, post-bronchodilator FEV1/FVC, ADO index and VQ11 total score were 64±8 years, 0.55±0.08, 4.8±1.7 and 2±10, respectively. A significant "r" (0.56) was identified between the ADO index and the total score. Psychological, relational and total scores of GOLD "A-B" patients were significantly lower than those in GOLD "C-D" patients: 10±4 vs. 12±3, 11±4 vs. 13±3 and 30±11 vs. 36±7, respectively. CONCLUSION: The Arabic version of VQ11 is applicable in Tunisian COPD patients with reliable results.

[The plethysmographic reference equations established for adult natives of Eastern Algeria are not applicable to natives of Northern Algeria]. / Les équations de référence pléthysmographiques établies chez les adultes natifs de l'Est Algérien sont inapplicables pour ceux natifs du Nord Algérien.

INTRODUCTION: The validity of the published plethysmographic reference equations specific to adults living in Eastern Algeria (RE-EA) in the interpretation of spirometric results in adult natives of Northern Algeria has not been assessed. AIM: To test the application of the RE-EA (Constantine, mean altitude=694m) to a population of healthy adults living in Algiers (mean altitude=153m). METHODS: The plethysmographic parameters of 453 healthy adults living in Algiers (234 women; age: 45±15 years, height: 1.66±0.10m, weight: 73±14kg) were determined and were compared with those predicted from the RE-EA. In addition, the percentages of adults with an obstructive ventilatory defect (OVD), a restrictive ventilatory defect (RVD) and/or lung hyperinflation were noted. The RE-EA are considered inapplicable to healthy adults living in Algiers if, firstly, the differences between the determined and predicted plethysmographic parameters are statistically significant and, secondly, more than 5% of healthy adults have OVD and/or RVD and/or lung hyperinflation. RESULTS: The RE-EA significantly overestimated the following parameters: FEV1 by 0.27±0.39L, MMEF by 0.52±0.75L/s, FEF25% by 0.75±0.56L/s, FEF50% by 0.85±1.02L/s, FEF75% by 0.28±1.25L/s, VC by 0.21±0.50L, TLC by 0.31±0.62L, ERV by 0.06±0.48L, IC by 0.27±0.48L, FEV1/VC by 0.03±0.05, and FEV1/FVC by 0.03±0.05. They significantly underestimated the RV/TLC by 0.01±0.05. Moreover, 14.35 %, 8.83 % and 5.74 % of healthy adults had OVD, RVD and lung hyperinflation, respectively. CONCLUSION: The RE-EA are not applicable in adult natives of Northern Algeria.

Understanding of plagiarism among North-African university hospital doctors (UHDs): A pilot study.

No previous North-African study has evaluated the UHDs understanding of plagiarism (UP). This descriptive study aimed to assess UP among Tunisian UHDs. UHDs were recruited via electronic mails sent to all the Tunisian UHDs through the national health networks and by convenience sampling via a questionnaire provided directly to some UHDs. The French survey, available from the Laval University website, includes 11 questions related to UP, with three-choice answers (yes/no/may be). One point was awarded for each correct answer. A total score lower than six corresponded to a low level of UP. 96 UHDs (69 females) responded to the survey either through emails (39.6%) or by filled in the paper (60.4%). The mean ±SD (95% confidence interval) score of UP was considered low at 5.4 ± 1.9 (5.0 to 5.8); 74% of the participants had a low UP. The UP score was significantly different between the categories of assistants and professors. Data comparison between subjective and objective assessments revealed that significant percentages of UHDs underestimated their low UP. This was more marked in the professors' category. There was no significant correlation between the UP total score and the UHDs' age or professional experience. To conclude, plagiarism is not well-known to North African UHDs. Abbreviations: MD: medical doctor; MSc: master of sciences; PhD: doctor of philosophy; r: Spearman correlation coefficient; SD: standard deviation; UHDs: university hospital doctors; UP: understanding of plagiarism; 95% CI: 95% confidence interval.

[Evaluation of quality of life (QOL) of Tunisians patients with COPD]. / Évaluation de la qualité de vie (QDV) des patients tunisiens atteints de bronchopneumopathie chronique obstructive (BPCO).

AIM: To test the Arabic version of the St. George's Hospital Respiratory Questionnaire (SGRQ) in stable Tunisian COPD patients. HYPOTHESES: A correlation coefficient between the post-bronchodilator FEV1 and the "Total" score of SGRQ higher than "-0.40", and QOL scores lower in COPD with "mild to moderate airway obstruction" than in those with "severe to very severe airway obstruction" will be in favor of a possible application of the Arabic version of the SGRQ in Tunisians COPD patients. METHODS: This is a prospective cross-sectional study including 50 clinically stable COPD patients. The Arabic version of the SGRQ was used. Four scores were calculated for the "Symptoms", "Activities", "Impacts" and "Total" components. Patients were divided into two groups according to the severity of their airway obstruction: "mild to moderate, n=30" and "severe to very severe, n=20". The correlation between the QOL "Total" score and postBD FEV1 was evaluated. RESULTS: The mean±SD of age, cigarette smoking and post-bronchodilator FEV1 were, respectively, 60±10, 61±36 pack-years and 55±20 %. The correlation between the post-bronchodilator FEV1 and QOL "Total" score was significant at "-0.65". "Symptoms", "Activities", "Impacts" and "Total" scores were significantly less altered in patients with "mild to moderate airway obstruction" than among those with "severe to very severe airway obstruction" (respectively, 52±24 vs. 77±17, 66±28 vs. 87±18, 48±25 vs. 70±23 and 54±22 vs. 76±17). CONCLUSION: The application of the Arabic version of the SGRQ in stable COPD patients gives reliable results.

[Systemic inflammatory profile of smokers with and without COPD]. / Profil inflammatoire systémique des fumeurs atteints de BPCO comparés aux fumeurs indemnes de BPCO.

INTRODUCTION: Studies comparing the systemic inflammatory profiles of smokers with and without COPD present discordant findings. AIM: To compare the systemic inflammatory profile of smokers with and without COPD. METHODS: This is a cross-sectional comparative study. Two groups of active smokers of more than 10 pack-years were included: 56 consecutives stable COPD (postbronchodilator FEV1/FVC<0.70) and 32 consecutives non-COPD (postbronchodilator FEV1/FVC≥0.70). Smoking and clinical, anthropometric and spirometric data were noted. The following blood biomarkers were identified: leukocytes, hemoglobin, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR). According to the levels (normal/abnormal) of these markers, two groups of smokers were formed. Quantitative and qualitative data were expressed, respectively, as means±SD and percentages. RESULTS: Compared to the non-COPD group, the COPD group was older (56±12 vs. 65±8 years) and had a higher smoking consumption (30±18 vs. 52±31 pack-years). Compared to the non-COPD group, the COPD group had higher values of CRP (2.06±1.24 vs. 11.32±11.03mg/L), of ESR (9.59±8.29 vs. 15.96±11.56), of IL-6 (9.28±4.69 vs. 20.27±5.31ng/L) and of TNF-α (18.38±7.98ng/L vs. 8.62±3.72ng/L). Compared to the non-COPD group, the COPD group included higher percentages of smokers with elevated CRP (0 % vs. 32 %), with leukocytosis (6 % vs. 16 %), with higher levels of IL-6 (81 % vs. 98 %) or TNF-α (91 % vs. 100 %). CONCLUSION: Smokers with COPD, compared to smokers free from COPD, have a marked systemic inflammation.

Methyl thiophanate-induced toxicity in liver and kidney of adult rats: a biochemical, molecular and histopathological approach.

The aim of this study was to elucidate the redox effects of Thiophanate methyl (MT) in the rat liver and kidney. Our results showed, after 3 days of MT injection (700 mg/kg), an increase in malondialdehyde (MDA), hydrogen peroxide and advanced oxidation protein products levels. Glutathione peroxidase and superoxide dismutase activities were also remarkably increased in the liver but decrease in the kidney. Glutathione and vitamin C values were significantly reduced. The changes in biochemical parameters were substantiated by histological and molecular data. A smear without ladder formation on agarose gel was shown, indicating random DNA degradation in the liver and the kidney of MT treated rats. The increase in cyclooxygenase-2 gene expression, marker of inflammation, and an increase in genes expression of glutathione peroxidase and superoxide dismutase in liver and their decrease in the kidney were also occurred after MT exposure. These data confirmed the pro-oxidant and genotoxic effects of this fungicide.

Dandelion-enriched diet of mothers alleviates lead-induced damages in liver of newborn rats.

Lead (Pb) is a highly toxic metal present in the environment. It causes disturbances of several functions, including hematologic, renal, reproductive and nervous ones. Preventive or curative use of medicinal plants against these disorders may be a promising and safe therapeutic strategy. This study evaluated the hepatic toxic effects of prenatal exposure to lead in rats and the possible protective effect of dandelion (Taraxacum officinale) added to the diet. Female rats were given a normal diet (control) or a diet enriched with dandelion (treated). In addition, lead acetate was administered to half of the rats through drinking water from the 5th day of gestation until the 14th day postpartum. Lead toxicity was evaluated in their offspring by measuring body and liver weights, plasma biochemical parameters, liver damage, as well as protein content and activities of antioxidant enzymes in the liver tissues. Lead poisoning of mothers caused lead deposition in blood and stomach of their pups as well as hepatic tissue damages. Moreover, significant decreases in liver weight and protein content were found. Lead treatment caused oxidative stress and marked changes in the activity of antioxidant enzymes. However, no damages or biochemical changes were observed in puppies from the rats co-treated with lead and dandelion. These results indicate that supplementation of pregnant and lactating rats with dandelion protects their offspring against lead poisoning, likely through reduction of oxidative stress and liver damages.

[Sub-maximal aerobic capacity and quality of life of patients with rheumatoid arthritis]. / Aptitude aérobie sous-maximale et qualité de vie des patients atteints de polyarthrite rhumatoïde.

BACKGROUND: Studies about sub-maximal aerobic capacity of patients with rheumatoid arthritis are scarce. AIMS: To assess the sub-maximal aerobic capacity of these patients through the 6-min walk test, estimated age of the "muscular and cardiorespiratory" chain. METHODS: Thirty-seven consecutive patients (aged 20 to 60 years) with newly diagnosed rheumatoid arthritis will be included. Non-inclusion criteria will be: use of drugs (e.g.; methotrexate, beta-blockers), orthopaedic or rheumatologic conditions (other than rheumatoid arthritis) that may alter walking ability and recent infections. Exclusion criteria will be: 6-min walking test contra-indications and imperfect performance of the required lung function and walking maneuvers. Signs of walking intolerance will be: test interruption, distance ≤lower limit of normal, dyspnea score ≥5/10 (visual analogue scale) at the end of the test, haemoglobin oxygen saturation (SpO2) drop ≥5%, cardiac frequency at the end of the test ≤60% of maximum predicted. An estimated "muscular and cardiorespiratory chain" age higher than the chronological one will be considered as a sign of accelerated ageing. EXPECTED RESULTS: A high percentage of patients suffering from rheumatoid arthritis would show evidences of walking limitation and accelerated "muscular and cardiorespiratory chain" ageing. There would be a significant correlation between the walking test and clinical, biological, radiological and pulmonary function data and the patients' quality-of-life status.

Spirulina exhibits hepatoprotective effects against lead induced oxidative injury in newborn rats.

Lead is a toxic metal that induces a wide range of biochemical and physiological effects. The present investigation was designed at evaluating the toxic effects of a prenatal exposure to lead of mothers on hepatic tissue of newborn rats, and potent protective effects of spirulina. Female rats were randomly divided into 4 groups which were given a normal diet (control),a diet enriched with spirulina (S), lead acetate administered through drinking water (Pb), or a diet enriched with spirulina and lead contaminated water (S Pb), respectively. The duration of treatments was from the 5th day of gestation to 14 days postpartum. Lead toxicity was assessed by measuring body and liver weights, blood and stomach lead levels, hepatic DNA, RNA and protein amounts, blood enzyme activities (AST and ALT), as well as lipid peroxidation level and activities of antioxidant enzymes in hepatic tissues of neonates. Lead intoxication of mothers caused reduction of liver weight as well as of hepatic DNA, mRNA and protein levels in newborns. Moreover, oxidative stress and changes in antioxidant enzyme activities were recorded. Conversely, supplementation of mothers with spirulina mitigated these effects induced by lead. These results substantiated the potential hepatoprotective and antioxidant activity of spirulina.

Critical appraisal of the clinical utility of sublingual immunotherapy in allergy.

Since it was introduced by Noon in 1911, allergen-specific immunotherapy or desensitization has been widely prescribed in the management of allergic diseases. Aimed at the etiology, it represents the only effective treatment for allergy. The basic mechanisms of immunotherapy are becoming better understood and allow us to improve this technique in the future. The sublingual immunotherapy as an alternative to subcutaneous route has been widely studied. Several clinical trials confirmed that sublingual immunotherapy is efficient in reducing allergic respiratory symptoms. The sublingual immunotherapy reduces the risk of developing serious side effects due to desensitization. We performed a literature review in order to remind the mechanisms of action and to demonstrate efficacy and tolerability of the sublingual immunotherapy in the treatment of allergic rhinoconjunctivitis and asthma and its impact on the quality of life.

Ameliorative effects of vanillin on potassium bromate induces bone and blood disorders in vivo.

The objective of this study was to investigate the propensity of potassium bromate (KBrO3) to induce oxidative stress in blood and bone of adult mice and its possible attenuation by vanillin. Our results demonstrated, after KBrO3 treatment, a decrease of red blood cells and hemoglobin and a significant increase of white blood cell. A decrease in plasma levels of folic acid, vitamin B12 and iron was also noted. Interestingly, an increase of lipid peroxidation, hydroperoxides, hydrogen peroxide, advanced oxidation protein products and protein carbonyl levels in erythrocytes and bone was observed, while superoxide dismutase, catalase and glutathione peroxidase activities and glutathione, non-protein thiol and vitamin C levels were decreased. KBrO3 treatment resulted in blood and bone DNA fragmentation, a hallmark of genotoxicity-KBrO3-induced, with reduction of DNA levels. Calcium and phosphorus levels showed a decrease in the bone and an increase in the plasma after KBrO3 treatment. These biochemical alterations were accompanied by histological changes in the blood smear and bone tissue. Treatment with vanillin improved the histopathological, hematotoxic and genotoxic effects induced by KBrO3. The results showed, for the first time, that the vanillin possesses a potent protective effect against the oxidative stress and genotoxicity in bone and blood of KBrO3-treated mice.

[The importance of lung volumes in the investigation of heavy smokers]. / Place de la distension pulmonaire dans l'exploration des gros fumeurs de cigarettes.

INTRODUCTION: Lung hyperinflation (LH) has become a major concern in the management of chronic obstructive pulmonary disease (COPD). MAIN AIM: To evaluate the role of lung volumes in the positive diagnosis of COPD and in the assessment of airway obstruction reversibility. POPULATION AND METHODS: Three hundred and sixty-six male smokers over the age of 35 with more than 40 pack-years exposure were included in the study. Plethysmographic data were determined before/after taking a bronchodilator (BBD, ABD). Applied definitions: airflow obstruction: BBD FEV1/FVC<0.70. LH: BBD residual volume (RV)>upper limit of normal. Expressions of reversibility: Δvariable=(ABD-BBD) values; Δinit%=Δvariable/BBD value and Δref%=Δvariable/reference value. A 12%init and a 0.2L increase in either FEV1 or FVC or a 10%ref or - 300 mL decrease in RV were considered as clinically significant. RESULTS: Over the 85 smokers without airflow obstruction, 68% had LH. In the hyperinflated group (n=314), and compared to changes in FEV1 and FVC, these RV changes detected more respondents (54% for FEV1 and FVC vs. 65% for RV, P=0.002). This was not the case for the group free from LH (n=52) (23% for FEV1 and FVC vs. 35% for RV, P=0.09). In the 58 hyperinflated groups free from airflow obstruction, and compared to changes in FEV1 and FVC, changes in RV detected more respondents (24% for FEV1 and FVC vs. 71% for RV, P=0.0001). CONCLUSION: In heavy smokers, it seems essential to include LH as a criterion for a positive diagnosis of COPD and of reversibility evaluation.

[Pulmonary function in rheumatoid arthritis in a Tunisian population]. / La fonction respiratioire dans la polyarthrite rhumatoïde chez une population tunisienne.

BACKGROUND: The rheumatoid polyarthritis (PR) is a frequent pathology in Tunisia. The most frequent extra articular expression of this disease is in the respiratory tract. AIM: To determine the lung functional profile of PR of the Tunisian population by establishing possible relations between ventilatory variables and clinico-biological parameters of PR. METHODS: It is a cross sectional study which concerned 87 patients (77 women) having a confirmed PR. They benefited from a measure of the lung function by a total physical Pléthysmography and by the technique of double transfer NO-CO. Clinical and biological checkup were realized. RESULTS: Three kinds of pulmonary function defects were found: obstructive ventilatory defect (13%), restrictive defect (7%) and mixed defect (1%). Ventilatory flows and the lung volumes correlated negatively with the inflammatory syndrome (p<0.05). Alveolar-capillary diffusion capacity (DLco) was altered in an isolated way or associated with the respiratory functional syndromes (obstructive and restrictive) (6%). This abnormality had a vascular origin with an isolated fall of the lung capillary volume (Vc), a membrane origin with an isolated fall of the diffusion membrane (DM) or a combined origin with the decline of Vc and DM. This latter case was found at a late stage of PR. 58% of PR patients had a normal pulmonary function. CONCLUSION: All these functional findings were linked to PR itself (inflammatory and auto-immune origin) or to the lung toxicity due to the treatment by Methotrexate (alveolar and bronchial damage).

Spirometric profile of narghile smokers.

INTRODUCTION: Studies of the spirometric profiles of narghile smokers are few, have some methodological limits (i.e. small sample size), and present contradictory conclusions. AIMS: (i) To determine the percentage of narghile smokers with obstructive ventilatory defect (OVD) and/or restrictive ventilatory defect (RVD) or static hyperinflation (SHI); (ii) to compare the chronological and estimated lung ages. INCLUSION CRITERIA: men aged 20 to 60 years, narghile smokers (>1 narghile-year [NY]). EXCLUSION CRITERIA: cigar or cigarette smokers and comorbidity. Narghile use quantification: NY and kg of cumulative tobacco use (1 NY=9.125 kg of cumulative tobacco use). DEFINITIONS: Large airway obstructive ventilatory defect (OVD): forced expired volume in one second (FEV(1))/forced vital capacity (FVC) less than lower limit of normal (LLN). Small airway OVD: FVC more than LLN and decrease (less than LLN) of one or more peripheral flows. RVD: total lung capacity (TLC) less than LLN. SHI: residual volume (RV) more than upper limit of normal. SPIROMETRIC MEASURES: (Vmax 22 Series/6200 Autobox, SensorMedics, Yorba Linda, California, USA with measurement of functional residual capacity by nitrogen washout). Measurements were made according to international recommendations. RESULTS: One hundred and ten narghile smokers were included (34±10 years; 1.76±0.07m; 84±14kg). Thirty-six percent of the subjects had SHI; 14% had small airway OVD; 14% had RVD, and 6% had large airway OVD. Estimated lung age was higher than chronological lung age (47±18 years vs. 34±10 years, P<0.05). CONCLUSION: Narghile use accelerates lung ageing. This study provides the health authorities with valid arguments to fight this blight on society, which increasingly involves children and pregnant women.