Stewart D. Johnson

Efficacy and Safety of Galantamine in Patients with Dementia with Lewy Bodies: A 12-Week Interim Analysis

Observations on the neurochemistry of dementia with Lewy bodies (DLB) have suggested that cholinesterase inhibitors (ChEIs) might be beneficial in treating some clinical symptoms of DLB. A 24-week, multicenter open-label study was designed to assess the safety and efficacy of the ChEI galantamine in patients with DLB, and an interim analysis of results was performed at 12 weeks. Efficacy analyses were performed on data from 25 patients. Scores on the Neuropsychiatric Inventory (NPI-12) improved (decreased) by 7.52 points over the 12 weeks (marginally significant, p = 0.061). NPI-12 scores decreased by half in 12 of the 25 patients. Highly significant improvement was observed in scores on the NPI-4 subscale (delusions, hallucinations, apathy, and depression: p = 0.003). Scores on the Clinician’s Global Impression of Change (CGIC) improved by 0.95 points (significant, p = 0.02). Improvements also were found in secondary efficacy variables, including cognitive, functional, activities of daily living, sleep and confusion assessments. Motor scores, as measured by the UPDRS motor subscale, showed mild improvement, which demonstrates that galantamine has no adverse effect on parkinsonian symptoms. Adverse events generally were transient and of mild-to-moderate intensity. Two of the 25 patients discontinued galantamine because of nausea and anorexia. One serious adverse event was recorded, but it was judged to be unrelated to the study medication.

Efficacy and safety of Galantamine in patients with Dementia with Lewy bodies: A 24-week open-label study

Background: Dementia with Lewy bodies (DLB) is a common dementia of the elderly. A significant cholinergic deficit has been demonstrated that may be responsive to treatment by cholinesterase inhibitors (ChEIs). Methods: A 24-week, open-label study was designed to assess the efficacy and safety of a ChEI, galantamine, in 50 patients with DLB. Results: This study showed beneficial effects with galantamine in 2 of the 3 primary efficacy parameters. The scores on the Neuropsychiatric Inventory (NPI-12) improved by 8.24 points from baseline (p = 0.01) especially in visual hallucinations and nighttime behaviors (p = 0.004). The scores on the Clinician’s Global Impression of Change improved by 0.5 points from baseline (p = 0.01). The third primary efficacy parameter, the Cognitive Drug Research Computerized Cognitive Assessment System, was unchanged from baseline. Adverse events were generally mild and transient. Conclusion: Galantamine appears to be an effective and safe therapy for patients with DLB.

Singular measures without restrictive intervals

For the transformationT:[0,1]↦[0,1] defined byT(x)=λx(1−x) with 0≦λ≦4, a λ is shown to exist for whichT has no restrictive intervals, hence is sensitive to initial conditions, but for which no finite absolutely continuous invariant measure exists forT.

SIMPLE HYBRID SYSTEMS

A hybrid system is one which can instantaneously switch between a number of phase portraits. Switching occurs when trajectories hit prescribed switching curves. This type of system is highly applicable to digital controls such as robotic controls. A working definition of such a system is given, as well as a method for stabilizing periodic orbits and several examples.

Sex ratio and population stability

The ratio of males to females within a population can have a strong effect on the per capita growth rate. This paper contains a brief construction and discussion of a mathematical population model embodying sex ratio dynamics. Some implications of the model will be explored

Continuous measures in one dimension

AbstractFamilies of unimodal maps satisfying(1)Tλ: [−1,1]↦[−1,1] withT(±1)=−1 and |Tλ′(1)|>1.(2)Tλ(x) isC2 inx2 and λ, and symmetric inx.(3)T0(0)=0,T1(0)=1 with

Beyond Hyperbolicity: Expansion Properties of One-Dimensional Mappings

\frac{d}{{d\lambda }}

Distortion of S-unimodal maps

Tλ(0)>0are considered. The results of Guckenheimer (1982) are extended to show that there is a positive measure of λ for whichTλ has a finite absolutely continuous invariant measure.The appendix contains general theorems for the existence of such measures for some markov maps of the interval.