It is well known that physical inactivity increases the risk of global death; however, the impact of the coronavirus disease 2019 (COVID-19) lockdown strategy on physical activity (PA) remains unclear. This study compared PA—i.e., daily occupation, transportation to and from daily occupation, leisure time activities, and regular sporting activities—prior (PRE) and during (POST) the on-going COVID-19 outbreak in the Greece lockdown environment. A Greek version of the web-based Active-Q questionnaire was used to access PA. The questionnaire was filled out twice (once each for the PRE and POST conditions) by 8495 participants (age = 37.2 ± 0.2 years (95% confidence interval (CI), 36.9–37.5); males = 38.3% (95%CI, 36.7–40.0); females = 61.7% (95%CI, 60.4–63.0). The relative frequency of overall sporting activities, which, prior to lockdown, occurred at least once per month, and overall participation in competitive sports was significantly reduced (8.6% (95%CI, 7.9–9.3) and 84.7% (95%CI, 82.9–86.6) respectively). With the exception of overall leisure time activities, which were significantly increased in the POST condition, daily occupational, transportation, and sporting activities significant reduced (p < 0.05). Overall PA was reduced in all genders, age, body mass index (BMI) and PA level subgroups in the POST condition, and an interaction between the males and High PA subgroups was observed. The change in overall PA (from PRE to POST conditions) was −16.3% (95%CI, −17.3 to −15.4), while in daily occupational, transportation, and sporting activities, it was −52.9% (95%CI, −54.8–51.0), −41.1% (95%CI, −42.8–39.5) and −23.9% (95%CI, −25.1–22.8), respectively. Thus, the lockdown period is highly associated with a negative change in overall PA. During lockdown, inactivity increased dramatically, with males and the high PA population affected significantly more. The decline in PA is a great concern due to possible long-term consequences on public health and healthcare system.

Carbohydrate (CHO) supplementation during prolonged exercise postpones fatigue. However, the optimum administration timing, dosage, type of CHO intake, and possible interaction of the ergogenic effect with athletes’ cardiorespiratory fitness (CRF) are not clear. Ninety-six studies (from relevant databases based on predefined eligibility criteria) were selected for meta-analysis to investigate the acute effect of ≤20% CHO solutions on prolonged exercise performance. The between-subject standardized mean difference [SMD = ([mean post-value treatment group–mean post-value control group]/pooled variance)] was assessed. Overall, SMD [95% CI] of 0.43 [0.35, 0.51] was significant (p < 0.001). Subgroup analysis showed that SMD was reduced as the subjects’ CRF level increased, with a 6–8% CHO solution composed of GL:FRU improving performance (exercise: 1–4 h); administration during the event led to a superior performance compared to administration before the exercise, with a 6–8% single-source CHO solution increasing performance in intermittent and ‘stop and start’ sports and an ~6% CHO solution appearing beneficial for 45–60 min exercises, but there were no significant differences between subjects’ gender and age groups, varied CHO concentrations, doses, or types in the effect measurement. The evidence found was sound enough to support the hypothesis that CHO solutions, when ingested during endurance exercise, have ergogenic action and a possible crossover interaction with the subject’s CRF.

Background : Obturator hernias (OH) account for a rare presentation to the surgical unit usually associated with bowel obstruction and strangulation. The treatment of this condition is classical laparotomy with repair of the hernia and bowel resection, if deemed necessary; recently, the laparoscopic approach has been reported in literature. This review examines the existing evidence of the safety and effectiveness of the laparoscopic approach for the management of OH. Materials and Methods: We have conducted a systematic review of the cases reported in the literature between 1991 and 2009, using Medline with PubMed as the search engine, as well as Ovid, Embase, Cochrane Collaboration and Google Scholar databases to identify articles in English language reporting on laparoscopic management for the treatment of this condition. Results: A total of 17 articles reporting on 28 cases were found. We describe the pooled data for demographics, operative time, hospital stay, morbidities and method of repair. We also compare to the results of the laparoscopic repair of other types of hernias in the literature. Conclusion: This approach was found to be a safe and effective approach for the repair of OH as compared to the classical open approach; however, its adoption as the gold standard needs further multicenter trials.

Acute inguinal hernias are a common presentation as surgical emergencies, which have been routinely managed with open surgery. In recent years, the laparoscopic approach has been described by several authors but has been controversial amongst surgeons. We describe the laparoscopic approach to incarcerated/strangulated inguinal hernias based on a review of the literature with regards to its feasibility in laparoscopically managing the acute hernia presentation. A systematic literature search was carried out including Medline with PubMed as the search engine, and Ovid, Embase, Cochrane Collaboration, and Google Scholar databases to identify articles reporting on laparoscopic treatment, reduction, and repair of incarcerated or strangulated inguinal hernias from 1989 to 2008. Forty-three articles were found, and 7 were included according to the inclusion criteria set. Articles reporting on the use of laparoscopy for the evaluation of the hernia but not reducing and repairing it, the use of the open technique, elective hernia repairs, pediatric series, review articles, and other kinds of hernias were excluded after title and abstract review. This resulted in 16 articles that were reviewed in full. Of these 16 articles, 7 reported on the use of the laparoscopic approach exclusively. From these 7 studies, there were 328 cases reported, 6 conversions, average operating time of 61.3 minutes (SD±12.3), average hospital stay of 3.8 days (SD±1.2), 34 complications (25 of which were reported as minor), and 17 bowel resections performed either laparoscopically or through a minilaparotomy incision guided laparoscopically. The laparoscopic repair is a feasible procedure with acceptable results; however, its efficacy needs to be studied further, ideally with larger multicenter randomized controlled trials.