5 research outputs found
Harmonic analysis using in human visual system diagnosnics by means of elektroretinograms identification
This paper contain information of theoretical and practical aspects of biosignal measurement in
diagnostic equipment for visual system investigation. We shall consider some properties of signals being recorded, give the block diagram of a recording and dectroretinograms preprocessing system and analyze
some obtained result
Tiotropium versus Salmeterol for the Prevention of Exacerbations of COPD
BACKGROUND
Treatment guidelines recommend the use of inhaled long-acting bronchodilators to
alleviate symptoms and reduce the risk of exacerbations in patients with moderate-tovery-severe chronic obstructive pulmonary disease (COPD) but do not specify whether
a long-acting anticholinergic drug or a β2-agonist is the preferred agent. We investigated whether the anticholinergic drug tiotropium is superior to the β2-agonist
salmeterol in preventing exacerbations of COPD.
METHODS
In a 1-year, randomized, double-blind, double-dummy, parallel-group trial, we compared the effect of treatment with 18 μg of tiotropium once daily with that of 50 μg
of salmeterol twice daily on the incidence of moderate or severe exacerbations in
patients with moderate-to-very-severe COPD and a history of exacerbations in the
preceding year.
RESULTS
A total of 7376 patients were randomly assigned to and treated with tiotropium
(3707 patients) or salmeterol (3669 patients). Tiotropium, as compared with salmeterol, increased the time to the first exacerbation (187 days vs. 145 days), with a 17%
reduction in risk (hazard ratio, 0.83; 95% confidence interval [CI], 0.77 to 0.90;
P<0.001). Tiotropium also increased the time to the first severe exacerbation (hazard ratio, 0.72; 95% CI, 0.61 to 0.85; P<0.001), reduced the annual number of moderate or severe exacerbations (0.64 vs. 0.72; rate ratio, 0.89; 95% CI, 0.83 to 0.96;
P=0.002), and reduced the annual number of severe exacerbations (0.09 vs. 0.13;
rate ratio, 0.73; 95% CI, 0.66 to 0.82; P<0.001). Overall, the incidence of serious
adverse events and of adverse events leading to the discontinuation of treatment was
similar in the two study groups. There were 64 deaths (1.7%) in the tiotropium group
and 78 (2.1%) in the salmeterol group.
CONCLUSIONS
These results show that, in patients with moderate-to-very-severe COPD, tiotropium
is more effective than salmeterol in preventing exacerbations. (Funded by Boehringer
Ingelheim and Pfizer; ClinicalTrials.gov number, NCT00563381.
Gamma-Hydroxybutyrate Increases Resting-State Limbic Perfusion and Body and Emotion Awareness in Humans
Gamma-hydroxybutyrate (GHB) is a GHB-/GABA-B receptor agonist inducing a broad spectrum of subjective effects including euphoria, disinhibition, and enhanced vitality. It is used as treatment for neuropsychiatric disorders including narcolepsy and alcohol withdrawal, but is also a drug of abuse. Non-medical users report enhancement of body and emotion awareness during intoxication. However, the neuronal underpinnings of such awareness alterations under GHB are unknown so far. The assessment of regional cerebral blood flow (rCBF) by pharmacological magnetic resonance imaging (phMRI) enables the elucidation of drug-induced functional brain alterations. Thus, we assessed the effects of GHB (35 mg/kg p.o.) in 17 healthy males on rCBF and subjective drug effects, using a placebo-controlled, double-blind, randomized, cross-over design employing arterial spin labeling phMRI. Compared to placebo, GHB increased subjective ratings for body and emotion awareness, and for dizziness (p<0.01-0.001, Bonferroni-corrected). A whole-brain analysis showed increased rCBF in the bilateral anterior cingulate cortex (ACC) and the right anterior insula under GHB (p<0.05, cluster-corrected). ACC and insula rCBF are correlated with relaxation, and body and emotion awareness (p<0.05-0.001, uncorrected). Interaction analyses revealed that GHB-induced increase of body awareness was accompanied by increased rCBF in ACC, whereas relaxation under GHB was accompanied by elevated rCBF in right anterior insula (p<0.05, uncorrected). In conclusion, enhancement of emotion and body awareness, and increased perfusion of insula and ACC bears implications both for the properties of GHB as a drug of abuse as well as for its putative personalized potential for specific therapeutic indications in affective disorders