Comparative study of the effect of bilastine and cetirizine on cognitive functions at ground level and at an altitude of 4,000 m simulated in hypobaric chamber: a randomized, double-blind, placebo-controlled, cross-over study.

INTRODUCTION: Antihistamines are easily accessible and cover the vast majority of the medical therapy of allergic rhinitis. However, their systemic administration may more frequently associate with their well-known side-effect, sedation, which is a serious problem in persons in safety-critical jobs such as aviation. We have a poor understanding whether a non-sedative antihistamine has an impact on vigilance when hypobaric hypoxia occurs during flight. METHODS: In this randomized, placebo-controlled, double-blind, cross-over study the effect of 20 mg bilastine was compared to 10 mg cetirizine and to placebo (20 mg pyridoxine) in 33 individuals at ground level and at 4,000 m altitude simulated in hypobaric chamber. Levels of vigilance, ultrashort memory, combined distributive attention, monotony tolerance and peripheral blood oxygen saturation (SpO2) were assessed. RESULTS: Bilastine did not impair the tested abilities in comparison with the control groups either at ground level or hypobaric hypoxia. Administration of cetirizine increased the number of errors at ground level. At the simulated altitude, already impaired results were additionally demonstrated with regards to the distributive attention test. CONCLUSIONS: From the two examined antihistamines, bilastine should be the preferred medication for by individuals who require constant attention and are exposed to hypobaric hypoxia.

TNFα Variation During the Menstrual Cycle and Thereafter: A New Explanation for Gender-Based Disparities in ICU Admission Rates, Trauma Outcomes, and General Mortality.

BACKGROUND: Multiple studies have found gender-based disparities in intensive care unit (ICU) admission rates and in complications following trauma. Female gender was associated with lower mortality when comparing patients less than 50 years of age. These data suggest an important role for cycle rather than gender itself. Our previous results indicate a crucial role for tumor necrosis factor alpha (TNFα) in inducing nososocomial infections. HYPOTHESIS: Cycle is important for TNF and other female hormone productions. METHODS: Six older than 60 years old volunteers in both genders, 40 young female volunteers (no contraceptive drug, n = 18, contraceptive drug, n = 9, lactation, n = 9, pregnant, n = 4) were collected with following exclusion criteria, malignant disease, inflammation, infection, trauma and taking non-steroid anti-inflammatory drugs and antibiotics. Females were studied on days 1 and 14 of cycle. Serum TNFα was determined by HS TNF ELISA. Female hormones were also determined. RESULTS: Serum TNFα, estradiol, and progesterone individual values in volunteers with cycle (no contraceptive drug) demonstrate marked interindividual differences on day 1 and day 14 of cycle. It can be seen beside interindividual differences the personal difference between TNFα, estradiol, and progesterone values on day 1 and day 14.Serum TNFα, estradiol, and progesterone individual values in volunteers with no cycle (contraceptive drug yes) demonstrate marked interindividual differences on day 1 and day 14 of cycle. It can be seen beside interindividual differences the personal difference between TNFα, estradiol, and progesterone values on day 1 and day 14; furthermore, seemingly lower estradiol values on day 1 and day 14 between groups can be seen. A significant decrease was demonstrated in serum progesterone values on day 14 of group with contraceptive drug compared with group with no contraceptive one.A significant negative correlation is demonstrated between serum progesterone and serum TNFα values on day 14.A marked significant difference in serum TNFα values between volunteers with cycle and with no cycle, like contraceptive, lactation pregnancy (trimesters P1, P2, P3), and climax. CONCLUSION: For homogenous group of female patients not the gender and age are important but the cycle itself.

[Ocular signs of increased intracranial pressure]. / A koponyauri nyomásfokozódás szemtünetei.

Ocular signs developing as a result of increased intracranial pressure help the early diagnosis and prevention of severe and progressive pathological processes. Functional signs of the forming papillary oedema and central eye movement disorders may be predictors of increasing intracranial pressure. The functional tests of the antechiasmal optic nerve (i.e. the measurement of the visual field, fluorescein angiography of the retinal vessels, optic coherent tomography, ultrasound examinations of the carotid or vertebral arteries, and state-of-the-art neuroradiological methods) may provide help in determining the progression/remission of the increasing intracranial pressure and the efficacy of the treatment, and in differential diagnosis, as well. Adequate systemic therapy in time allows preventing irreversible incomplete or complete blindness, accompanied by the atrophy of the optic nerve, which is caused by increased intracranial pressure.

[The history, ingredients and effects of energy drinks]. / Az energiaitalok története és hatása az emberi szervezetre.

The market and the degree of the consumption of energy drinks is increasing every year, but only a few have global knowledge of their ingredients and actual physiological effects. Furthermore, the number of available publications that really go into the details in this topic is also rather poor. After a short historical introduction, this article reviews the contents of energy drinks, lists a few products distributed in Hungary and abroad as a comparison, and provides information on their physical and mental effects on the human body. In the end of the article the authors word the limitations of energy drink consumption.

A 10-year follow-up of ischemic heart disease risk factors in military pilots.

INTRODUCTION: Cardiovascular diseases (CVDs) represent the reason for approximately 10% of all groundings among military pilots. After their first screening examination, which decides their fitness for flight, pilots are required to appear for screening examinations yearly, which makes it possible to monitor the changes in the risk factors of ischemic heart disease (IHD) from their candidate days until their retirement or final grounding. SUBJECTS AND METHODS: During regular fitness screenings, we determined the individual and common occurrence and changes of recorded or measured IHD risk factors on the basis of 10- (baseline), 5-, and 0-year (current) data in the cases of 250 active male military pilots, broken down into 5-year age groups. In addition, by the help of complex risk calculation methods, we calculated the 5- and 10-year risk of coronary artery disease and CVDs, respectively. RESULTS: In the first year of the examinations, the following risk factors appeared: positive family history (25.0%), obesity (40.8%), smoking (31.7%), physical inactivity (23.9%), high blood pressure (14.7%), hypercholesterolemia (53.9%), pathological electrocardiogram deviations (1.3%). By aging, the occurrence of each risk factor remained unchanged or increased and their cumulative occurrence became more frequent, except for those above 45 to 50 yrs, who seldom had four or more risk factors at the same time. The cardiovascular risk calculated by the Futrex program was elevated in 40% of the study population (levels 3 and 4). By aging, the indices received by complex risk calculation methods deteriorated in the age group 25 to 45 years, while they improved in the age group of >45 years. The 5-year risk of CVDs was below 2.5% in half of the study population and it did not exceed 15 to 20% even in the age group with the highest risk. DISCUSSION: Based on reference data, pilots usually represent a healthier population in those countries where coronary artery diseases are leading health problems. In Hungary, many young pilots leave the army due to its currently ongoing transformation, while the elder are less motivated to change careers. It is probably the role of the stricter physical fitness test and screening examinations, and the effect of military propaganda targeting health conservation, that is in the background of the elder pilots' value improvements. It is also an influencing factor that by administering antilipid and antihypertensive medication based on NATO recommendations in the cases of those with increased risk, the probability of the development of IHD decreases and the affected pilots can be kept longer in service.

Hypobaric hypoxia reduces the amplitude of oscillatory potentials in the human ERG.

PURPOSE: To explore the retinal functions in healthy volunteers during acute hypoxic exposure, applying a set of electrophysiological tests. METHODS: Standard electroretinograms (ERGs) of the retina (rod-(scotopic) ERGs, cone-(photopic) ERGs, maximal responses and oscillatory potentials (OPs)) and 30-Hz flicker ERGs were recorded according to ISCEV (International Society of Clinical Electrophysiology of Vision) recommendations in 14 healthy volunteers during a 15-min exposure to a simulated altitude of 5500 m. RESULTS: The mean arterial oxygen saturation level was significantly reduced (P < 0.001) during the hypobaric challenge. It returned to the normal level very shortly after the end of the hypoxic exposure. No significant change in the latency or amplitude of the slow components of the ERG was found in any recording. The OPs of the ERG, however, revealed a significant decrease in amplitude during hypoxic exposure. Both OP1 and OP2 amplitudes were significantly different (P < 0.05) from the baseline values during hypoxia. Partial recovery of these waves occurred after termination of the hypoxia. CONCLUSIONS: These results appear to support the notion that the inner layers of the retina presumed to be the main source of the OPs, display the highest sensitivity towards circulatory and/or hypoxic challenges.

Short-term hypobaric hypoxia enhances visual contrast sensitivity.

The effect of hypoxia on early visual functions remains a controversial area of research. To explore this question, we measured static and dynamic visual contrast sensitivity in 14 healthy volunteers at a simulated altitude of 5500 m. In comparison with the baseline condition (mean arterial oxygen saturation: 98.4%), contrast sensitivity significantly increased after 5, 10 and 15 min of hypoxic exposure (saturation: 82.9%, 77.0%, 74.3%, respectively). After 10 min, this enhancement was markedly pronounced under dynamic conditions. Returning to the baseline altitude (saturation: 97.7%), contrast sensitivity recovered, mostly at the lower spatial frequencies. There was a significant negative relationship between arterial oxygen saturation and contrast sensitivity values at low and medium spatial frequencies (0.5-4.8 c/deg). These results suggest that early visual processing may be enhanced during short-term hypoxic challenge.