Effectiveness of Circadian countermeasures in simulated transmeridian flight schedules

The symptoms of jet-lag commonly afflict travelers who cross time zones. Insomnia during the new night, daytime fatigue, malaise, sleepiness, and gastrointestinal disturbances can occur for as long as 3 weeks after jet travel across even a few time zones. These symptoms are largely due to the slow rate of adjustment of the internal circadian timing system to the new time zone. Since business (or pleasure) can be seriously interrupted by such symptoms, it is important to determine ways to speed up the adjustment process to ameliorate the symptoms. Airline pilots have reported that they frequently nap to counter jet lag symptoms, and that they view this as a useful technique. Napping as a countermeasure would be attractive since it is practical and would take advantage of a naturally occurring phase of sleepiness after lunch. Napping also makes sense since insomnia is a common jet lag symptom. Thus, a laboratory simulation of jet lag was designed to test the ability of napping to increase the rate of adjustment following a time zone shift in a population of middle-aged men

El sue\uf1o en la vida de la mujer desde la madurez hasta la menopausia

Hay numerosas publicaciones que corroboran que el sue\uf1o en la mujer es distinto en muchos aspectos al del var\uf3n. Sin embargo, m\ue1s importante que las diferencias sexuales es el sue\uf1o dentro de ciertos grupos de mujeres. Por ejemplo, dentro del grupo de mujeres adultas de 20 a 45 a\uf1os de edad hay varios subgrupos: aquellas que tienen un ciclo menstrual regular, otras que toman anticonceptivos, otras que se encuentran embarazadas, otras lactando y otras m\ue1s que afrontan la menopausia. Cada uno de estos estados se acompa\uf1a de un ambiente hormonal \ufanico, as\ued que es importante definir si hay diferencias cl\uednicas considerables en el sue\uf1o de las mujeres durante estas fases de la vida. En este art\uedculo se describe todo lo que se sabe en la actualidad sobre el sue\uf1o en la mujer desde la madurez hasta la menopausia y se proponen algunas sugerencias para su evaluaci\uf3n y tratamiento

Donepezil in Parkinson's disease dementia: A randomized, double-blind efficacy and safety study

Parkinson's disease dementia (PDD) is associated with cholinergic deficits. This report presents an efficacy and safety study of the acetylcholinesterase inhibitor donepezil hydrochloride in PDD. PDD patients (n = 550) were randomized to donepezil (5 or 10 mg) or placebo for 24 weeks. Coprimary end points were the Alzheimer's Disease Assessment Scalecognitive subscale (ADAS-cog) and Clinician's Interview-Based Impression of Change plus caregiver input (CIBIC+; global function). Secondary end points measured executive function, attention, activities of daily living (ADLs), and behavioral symptoms. Safety and tolerability were assessed. ADAS-cog mean changes from baseline to week 24 (end point) were not significant for donepezil in the intent-to-treat population by the predefined statistical model (difference from placebo: -1.45, P = .050, for 5 mg; -1.45, P = .076, for 10 mg). Alternative ADAS-cog analysis, removing the treatment-by-country interaction term from the model, revealed significant, dose-dependent benefit with donepezil (difference from placebo: -2.08, P = .002, for 5 mg; -3.31, P < .001, for 10 mg). The 10-mg group, but not the 5-mg group, had significantly better CIBIC+ scores compared with placebo (3.7 vs 3.9, P = .113, for 5 mg; 3.6 vs 3.9, P = .040, for 10 mg). Secondary end pointsMiniMental State Exam; DelisKaplan Executive Function System; Brief Test of Attention, representing cognitive functions particularly relevant to PDDshowed significant benefit for both donepezil doses (P = .007). There were no significant differences in ADLs or behavior. Adverse events were more common with donepezil but mostly mild/moderate in severity. Although the study did not achieve its predefined primary end points, it presents evidence suggesting that donepezil can improve cognition, executive function, and global status in PDD. Tolerability was consistent with the known safety profile of donepezil. (C) 2012 Movement Disorder Societ