994 resultados para Wilcox, Gary


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Edgard Vare` se’s Poe` me e´ lectronique can be viewed as a bridge between early twentieth-century modernism and electroacoustic music. This connection to early modernism is most clearly seen in its use of musical juxtaposition, a favoured technique of early modernist composers, especially those active in Paris. Juxtaposition and non-motion are considered here, particularly in relationship to Smalley’s exposition of spectromorphology (Smalley 1986), which in its preoccupation with motion omits any significant consideration of non-motion. Juxtaposition and non-motion have an important history within twentieth-century music, and as an early classic of electroacoustic music, Poe` me e´ lectronique is a particularly striking example of a composition that is rich in juxtapositions similar to those found in passages of early modernist music. Examining Poe` me e´ lectronique through the lens of juxtaposition and non-motion reveals how the organisation of its juxtaposed sounds encourages the experience of sound structure suspended time.

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Aim: Flow-mediated dilation (FMD) is a surrogate marker of endothelial function, which has been proposed as a barometer of vascular health. Impaired microvascular response to reactive hyperaemia is thought to be the mechanism behind reduced shear stress and subsequently impaired FMD, which has been associated with cardiovascular events. This study aims to assess the effect of pioglitazone on the vasculature of patients with impaired glucose tolerance (IGT).

Materials and Methods: Forty IGT patients with no cardiovascular disease were compared with 24 healthy age- and sex-matched controls. Endothelial function was assessed using FMD of the brachial artery. Adiponectin (ADN) levels were measured and insulin sensitivity was calculated using homeostasis model assessment of insulin resistance (HOMA-IR). A randomised double-blind placebo-controlled trial of the IGT subjects was then performed, with subjects receiving either pioglitazone 30 mg od or matched placebo for 12 weeks before the measurements were repeated.

Results: The IGT subjects had a significantly impaired FMD compared with the controls (p < 0.001). Diastolic shear stress (DSS) was also significantly reduced in IGT (p = 0.04). High molecular weight (HMW) ADN was significantly lower in the IGT group than in controls (p = 0.03). On analysis of the IGT group after 12 weeks treatment, FMD was significantly increased in the pioglitazone group compared with placebo (p = 0.03) as was endothelium-independent dilation (EID) (p = 0.03). A significant increase in total ADN (p < 0.001), HMW ADN (p < 0.001) and HMW/total ratio (p = 0.001) occurred in the pioglitazone group compared with placebo.

Conclusions: Pioglitazone improved endothelial function in IGT. Treatment with pioglitazone may reduce the risk of cardiovascular disease in this patient group.