Influence of the menstrual cycle on flight simulator performance after alcohol ingestion

OBJECTIVE: Previous studies investigating the influence of the menstrual cycle on cognitive functioning of women after alcohol ingestion have obtained inconsistent results. The present study tested the hypothesis that flight simulator performance during acute alcohol intoxication and 8 hours after drinking differs between the menstrual and the luteal phase of the menstrual cycle. METHOD: White female pilots (N = 24) were tested during the menstrual and the luteal phases of their menstrual cycles. On each test day they performed a baseline simulator flight, consumed 0.67 g/kg ethanol, and performed an acute-intoxication and an 8-hour-carryover simulator flight. RESULTS: Subjects reached highly significant increases in estradiol (E2) as well as progesterone (P) levels during the luteal test day. Yet, there were no significant differences in overall flight performance after alcohol ingestion between the menstrual and luteal phases during acute intoxication or at 8-hour carryover. We found no correlations between E, or P levels and overall flight performance. However, there was a statistically significant Phase x Order interaction: Pilots who started the experiment with their menstrual day were less susceptible to the effects of alcohol during the second test day than were pilots who started with their luteal day. CONCLUSIONS: The tested menstrual cycle phases and varying E2 and P levels did not significantly influence postdrink flight performance. Because the present study included a comparatively large sample size and because it involved complex "real world" tasks (piloting an aircraft), we believe that the present findings are important. We hope that our failure to detect menstrual cycle effects will encourage researchers to include women in their investigations of alcohol effects and human performance.     

Myopathy in the adult form of glycogenosis II. Two case reports and review of the literature

Clinical, neurophysiological, morphological and biochemical investigations were performed in 2 patients with the adult form of glycogenosis II and related to the findings of 58 well-documented cases published in the literature. According to these findings three types can be distinguished from each other. The first one is characterized by an involvement of the limb-girdle muscles only. The second type shows the same pattern with additional progressive insufficiency of the respiratory muscles. The third type presents with weakness of the respiratory muscles without any other severe muscle involvement. Our case 1 can be related to the first, our case 2 to the second type. EMG-studies in case 1 showed myopathic changes and myotonic discharges without clinical signs of myotonia. A myotonic pattern was described in one third of the published cases. In case 2 neurogenic changes as well as in 4 cases in the literature were found. The muscle biopsy is the diagnostic clue in the differential diagnosis of progressive myopathy in the adult. Patients with glycogenosis II show glycogen storage specially in type I-fibres. The enzyme defect can be confirmed biochemically in muscle tissue or cultured fibroblasts. Various therapeutic concepts have been tried in patients with glycogenosis II but most of them remain disappointing. A diet with a low carbohydrate and a high protein proportion was observed to be of some benefit. In patients with respiratory muscle involvement artificial ventilation support showed a positive effect on the general condition for some time.     

Hormone replacement therapy and longitudinal cognitive performance in postmenopausal women.

OBJECTIVE: The authors examined the impact of hormone replacement therapy (HRT) on longitudinal cognitive performance (controlling for mood state) in 69 community-dwelling, postmenopausal women. METHODS: The authors conducted a 5-year follow-up of cognitive performance in 37 postmenopausal HRT users and 32 non-users. The groups did not differ with respect to age, years of education, or inter-test interval. RESULTS: No main effect of HRT was observed on any of the cognitive measures, and depressive symptomatology did not affect the relationship between HRT and cognition. CONCLUSION: Overall, our findings do not suggest that HRT affects longitudinal cognitive performance in postmenopausal, community-dwelling older women.     

The Landry-Guillain-Barré-Strohl-syndrome. Prognosis in adults (author's transl)]

The clinical aspect of acute polyradiculitis (Landry-Guillain-Barré-Strohl syndrome) of 85 patients is resumed. 52 of these 85 patients were seen after an average of 5, 1 years, 8 were dead at the time of control and 25 could not be traced. Two patients died during the acute phase of polyradiculitis corresponding to a letality of 2%. 24 of the subjects (46%) had recovered completely, 28 (54%) showed some residual symptoms. Eleven patients (21%) had some residual weakness of hands and/or feet. Out of these eleven six (11% of total) were so much disabled that they received a disablement pension. 17 patients with slight sensory disturbances and/or some loss of reflexes were not handicapped in their every-day life. 20 patients were examined electrophysiologically during the follow-up. All the five patients with a pathological EMG also showed some clinical residual signs. A positive correlation between pathological conduction velocities in the median and/or deep peroneal nerve and clinical residua was only inconstantly found. Patients with severe tetraparesis during the acute phase had more often residual symptoms. The time from the maximum motor deficiency to the beginning of recovery was longer in the latter group than in patients without residual symptoms (23 respectively 8 days) while there was no difference of the time between the beginning of motor weakness and the maximum motor deficiency in the two groups. A treatment with ACTH and/or corticosteroids seemed not to influence the long term prognosis of the illness.     

Der Locus coeruleus bei der olivo-ponto-cerebellären Atrophie

Zusammenfassung Es werden kurz 2 Fälle von pathologisch-anatomisch typischer olivoponto-cerebellärer Atrophie beschrieben. In beiden Fällen finden sich unter anderem in der Literatur bisher selten beschriebene schwere Veränderungen des Locus coeruleus. Diese bestehen in einem Schwund der Ganglienzellen, abnorm reichlich freiem Pigment, Pigmentanhäufung in der Glia und entsprechender reaktiver Gliavermehrung. Die pathophysiologische Bedeutung dieser Veränderungen wird anhand der Literatur kurz diskutiert.     

Transient global amnesia after clioquinol: five personal observations from outside Japan.

Five personal observations of an acute amnestic episode in younger individuals after intake of clioquinol are described together with three observations from the medical literature. In five of these cases the episode began after an unusually large dose, in three after a therapeutic one with a latency of about 24 hours. The clinical aspect closely resembled classical transient global amnesia but the episode after clioquinol lasted longer (24 hours to three days) and a more or less extensive retrograde amnesia persisted permanently. In one patient after three tablets of Mexase a clioquinol concentration of 12 microgram/ml in plasma was found 24 hours after the specified dose, which is an unexpectedly high concentration compared to those reported as late as 24 hours after a single equal dose of Mexase or any other clioquinol-containing preparation. Another patient had a brief relapse two years after the first episode, after a single therapeutic dose of another clioquinol preparation.