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PubMed1995

Assessment of mental workload with task-irrelevant auditory probes.

A study was performed to examine the utility of an ERP-based irrelevant probe technique for the assessment of variations in mental workload. Ten highly trained Navy radar operators performed a simulated radar-monitoring task which varied in the density and type of targets to be detected and identified. This task was performed in the presence of a series of irrelevant auditory probes which the radar operators were instructed to ignore. Prior to performing the radar-monitoring task the subjects performed a block of auditory detection trials in which they were asked to respond to the occurrence of one of two low probability tones and ignore the other low probability tone along with a higher probability standard tone. ERPs were recorded from the occurrence of the tones in both the baseline and low and high workload radar-monitoring conditions. The amplitude of the N100, N200, and early and late mismatch negativity (MMN) components decreased from the baseline to the low load radar-monitoring task and again with an increase in the difficulty of the radar-monitoring task. P300 amplitude was sensitive only to the introduction of the radar-monitoring task. These results are interpreted with respect to the phenomenon of attentional capture and suggest that the ERP-based irrelevant-probe technique might prove an effective method for the nonintrusive evaluation of increases in mental workload in complex tasks.

Adult↗

PubMed2006

In-vehicle workload assessment: effects of traffic situations and cellular telephone use.

PROBLEM: Assessment of drivers' on-road workload is an important traffic safety consideration. This study was conducted to examine the effects of cellular phone communication on driving performance, with particular emphasis on variations in task demand in different traffic situations. METHOD: Twelve participants were asked to drive on urban roads and motorways with or without concomitant mathematical-addition tests relayed via cellular phone. Measurements included task and driving performance, physiological responses, and compensatory behavior. RESULTS: Analysis of task performance revealed that mean response time was markedly increased (11.9%) for driving on urban roads compared to motorways. The mean driving speed only decreased 5.8% in the presence of phone tasks in comparison to normal driving without distractions. In addition, overall physiological workload increased through compensatory behavior in response to the phone tasks. CONCLUSIONS: Driving with phone use in different traffic environments induced measurable variations in driver workload. IMPACT ON INDUSTRY: When faced with heavy traffic, a greater safety margin is typically adopted, with more lowered driving speed and restricted phone use, and it can be assumed that there is a general trade-off between tasks to preserve driving safety.

Adult↗

PubMed2002

Physical workload on neck and upper limb using two CAD applications.

The aim was to evaluate (1) the physical workload on neck and upper limb in computer-aided design (CAD) work; (2) the impact of two applications (PROFESSIONAL-CADAM and PRO/Engineering) and (3) two input devices (computer mouse and keyboard), as well as (4) sitting and standing work positions. Fifteen CAD operators were interviewed and examined physically. For nine subjects, the physical workload was measured: electromyography (EMG) of trapezius and forearm extensor muscles, inclinometry of the head, the upper back and upper arms, as well as wrist goniometry. The muscular load was low in CAD work, but the inter-individual variation was considerable. Neither the positions were extreme, nor the movements. The applications, per se, did not have a large impact on the workload, but because of the need for different input devices the effect was strong. Using a keyboard meant higher angular velocities than using a mouse. Hence, when choosing a new software, which requires mainly a mouse as input device, this has to be balanced against the risk of disorders.

Adult↗

PubMed2000

Event-related brain potentials to Memory Workload and 'Analytical-Specific Perception' (Mangina-test) in patients with early Alzheimer's Disease and in normal controls.

Our previous research with intra-cerebral event-related potentials in conjunction with an original Memory Workload Paradigm has shown that significant load effects for the N4 latency were found only for both amygdalae and the left posterior hippocampus as well as for both anterior neo-cortical regions of the temporal gyri. These same structures are also affected in Alzheimer's Disease. Therefore, based on our previous intra-cerebral findings, our present research was to use our novel Memory Workload Paradigm in conjunction with surface ERPs as neurophysiological markers to tap cerebral regions and functions involved in memory disorders pertaining to early Alzheimer's Disease as opposed to normal memory processes in age-matched normal control subjects. Moreover, the Mangina-Test which measures varying degrees of 'Analytical-Specific Visual Perception' was individually administered to all patients and controls in separate sessions. Results indicate that for the early Alzheimer's Disease group, a significant main effect for memory load was found for the P400 amplitude (F(3,30)=4.52, P<0.02) which was absent in the normal group. In particular, the P400 amplitude was significantly higher on posterior head regions for patients with early Alzheimer's Disease as opposed to age-matched normal subjects (F(7,140)=3.54, P<0.03) which distinguished both groups (F(1,20)=6. 13, P<0.03). For the P400 latency, a significant memory load effect was present only for the normal group (F(3,30)=11.26, P<0.01). The Mangina-Test performance clearly differentiated both groups (F(1, 19)=105.85, P<0.001). The present data provide the first valuable evidence that ERPs to our novel Memory Workload Paradigm are sensitive neurophysiological diagnostic markers which delineate the early clinical brain irregularities underlying early Alzheimer's Disease as opposed to the normal memory processes of age-matched normal subjects. In addition, their use could be valuable for the objective clinical follow-up of therapeutic interventions in early Alzheimer's Disease.

Aged↗

PubMed1999

Bio-energetic response of the heart to dopamine following brain death-related reduced myocardial workload: a phosphorus-31 magnetic resonance spectroscopy study in the cat.

OBJECTIVE: Long-term exposure of the donor heart to high dosages of dopamine in the treatment of brain death-related hemodynamic deterioration has been shown to reduce myocardial phosphocreatine (PCr) and adenosine triphosphate (ATP) in myocardial biopsy specimens and may preclude heart donation for transplantation. Short-term exposure to the acute catecholamine release during the onset of brain death has shown an unchanged PCr/ATP ratio using in vivo phosphorus-31 magnetic resonance spectroscopy (31P MRS). In this study 31P MRS was used to evaluate in vivo myocardial energy metabolism during long-term dopamine treatment. METHODS: Twelve cats were studied in a 4.7 Tesla magnet for 360 minutes. At t = 0 minutes, brain death was induced (n = 6). At 210 minutes, when myocardial workload in the brain-death group was reduced significantly, dopamine was infused (n = 12) at 5 microg/kg/min and its dose was consecutively doubled every 30 minutes and was withheld during the last 30 minutes of the experiment. Phosphorus-31 magnetic resonance spectra were obtained from the left ventricular wall during 5-minute time frames, and PCr/ATP ratios were calculated. The hearts were histologically examined. RESULTS: Although significant changes in myocardial workload were observed after the induction of brain death and during support and withdrawal of dopamine in both groups, the initial PCr/ATP ratio of 2.00+/-0.12 and the contents of PCr and ATP did not vary significantly. Histologically identified sub-endocardial hemorrhage was observed in 3 of 6 of the brain-dead animals and in 1 of 6 of the control animals. CONCLUSIONS: High dosages of dopamine in the treatment of brain death-related reduced myocardial workload do not alter PCr/ATP ratios and the contents of PCr and ATP of the potential donor heart despite histologic damage.

Adenosine Triphosphate↗

PubMed1997

Increased cardiac workload by adrenoceptor agonists for the estimation of potential antiischemic activity in a conscious rabbit model.

The antiischemic effect of drugs can be detected at a lower dose range if the cardiac workload is increased. A brief period of frequency-loading (ventricular overpacing = VOP) results in well-defined, reproducible changes in cardiac parameters in the conscious, chronically instrumented rabbit; however, rapid pacing frequently evoked ventricular tachycardia or even fatal ventricular fibrillation. Therefore, cardiac workload has been increased by i.v. administration of adrenoceptor agonists, such as isoproterenol (ISO), phenylephrine (PHE), and their combination, respectively. The doses applied (especially the combination of 2 micrograms/kg ISO and 16 micrograms/kg PHE, giving optimal changes) were sufficient to produce a marked elevation of both the ST segment in the intracavital electrogram and the left ventricular end-diastolic pressure, without evoking cardiac arrhythmias. We compared the effect of this adrenergic "test" stimulus with that of VOP on hemodynamic and electrophysiological parameters of the heart, and furthermore, on the modification of responses to both "test" stimuli by oral administration of the coronary vasodilator: Isosorbide-5-mononitrate (IS-5-N), given in a dose of 40 mg/kg. Both VOP- and ISO+PHE-induced changes were significantly attenuated by IS-5-N, and a temporal coincidence of the maximal effects was found as well. We reached the following conclusion: The combined administration of ISO and PHE not evoking fatal arrhythmias in the dose range applied can replace the more risky VOP as a "test" workload in the estimation of antiischemic action.

Adrenergic alpha-Agonists↗

PubMed2003

Breathing pattern and workload during automatic tube compensation, pressure support and T-piece trials in weaning patients.

BACKGROUND AND OBJECTIVE: Automatic tube compensation has been designed as a new ventilatory mode to compensate for the non-linear resistance of the endotracheal tube. The study investigated the effects of automatic tube compensation compared with breathing through a T-piece or pressure support during a trial of spontaneous breathing used for weaning patients from mechanical ventilation of the lungs. METHODS: Twelve patients were studied who were ready for weaning after prolonged mechanical ventilation (10.2 +/- 8.4 days) due to acute respiratory failure. Patients with chronic obstructive pulmonary disease were excluded. Thirty minutes of automatic tube compensation were compared with 30 min periods of 7 cmH2O pressure support and T-piece breathing. Breathing patterns and workload indices were measured at the end of each study period. RESULTS: During T-piece breathing, the peak inspiratory flow rate (0.65 +/- 0.20 L s(-1)) and minute ventilation (8.9 +/- 2.7L min(-1)) were lower than during either pressure support (peak inspiratory flow rate 0.81 +/- 0.25 L s(-1) minute ventilation 10.2 +/- 2.3 L min(-1), respectively) or automatic tube compensation (peak inspiratory flow rate 0.75 +/- 0.26L s(-1); minute ventilation 10.8 +/- 2.7 L min(-1)). The pressure-time product as well as patients' work of breathing were comparable during automatic tube compensation (pressure-time product 214.5 +/- 104.6 cmH2O s(-1) min(-1), patient work of breathing 1.1 +/- 0.4 J L(-1)) and T-piece breathing (pressure-time product 208.3 +/- 121.6 cmH2O s(-1) min(-1), patient work of breathing 1.1 +/- 0.4 J L(-1)), whereas pressure support resulted in a significant decrease in workload indices (pressure-time product 121.2 +/- 64.1 cmH2O s(-1) min(-1), patient work of breathing 0.7 +/- 0.4 J L(-1)). CONCLUSIONS: In weaning from mechanical lung ventilation, patients' work of breathing during spontaneous breathing trials is clearly reduced by the application of pressure support 7 cmH2O, whereas the workload during automatic tube compensation corresponded closely to the values during trials of breathing through a T-piece.

Adult↗

PubMed1986

Relationship of physicians' nonverbal communication skill to patient satisfaction, appointment noncompliance, and physician workload.

A field study of 28 residents in family practice was conducted. Physicians' self-reports of empathy, self-monitoring ability, and affective communication skill as well as their objectively measured nonverbal communication skills were examined as predictors of patient satisfaction, appointment noncompliance, and physician workload (schedule density). Physicians completed the Hogan Empathy Scale, Snyder Self-Monitoring Scale, Affective Communication Test, short form of the Profile of Nonverbal Sensitivity, and a nonverbal encoding task. Patient satisfaction with communication, affective care, and technical care was assessed using a 25-item, visit-specific satisfaction scale. Appointment records were used to determine the number of patients seen by each physician and the compliance of patients with scheduled appointments. Results indicated that the three self-report measures were unrelated to the measures of patient noncompliance and patient satisfaction, but self-reported affective communication ability was significantly correlated with physician workload. Objectively measured physician sensitivity to audio communication predicted patient compliance: More sensitive physicians experienced fewer unrescheduled appointment cancellations. Nonverbal encoding skill was significantly related to patient satisfaction with affective care and to physician workload.

Adult↗

PubMed2001

A European perspective on nosocomial urinary tract infections I. Report on the microbiology workload, etiology and antimicrobial susceptibility (ESGNI-003 study). European Study Group on Nosocomial Infections.

OBJECTIVES: To obtain information on the microbiology workload, etiology and antimicrobial susceptibility of urinary tract infection (UTI) pathogens isolated in European hospitals. MATERIALS AND METHODS: We collected data available in the microbiology units of a large sample of European hospitals regarding the laboratory workload, diagnostic criteria, and etiology and antimicrobial resistance of the urinary isolates collected on one day (the study day). RESULTS: Data were received from a total of 228 hospitals from 29 European countries. The average rate of urine samples cultured per 1000 admissions in 1999 was 324. The criteria to consider a positive urine culture as significant were quite variable; > or =10(4) colony-forming units (CFU)/mL for bacteria or > or =10(3) CFU/mL in the case of yeasts were the most used cut-off points. On the study day, a total of 607 micro-organisms from 522 patients with nosocomial UTI were isolated. The six most commonly isolated micro-organisms were, in decreasing order: Escherichia coli (35.6%), Enterococci (15.8%), Candida (9.4%), Klebsiella (8.3%), Proteus (7.9%) and Pseudomonas aeruginosa (6.9%). Pseudomonas was isolated more frequently in non-EU countries. The study data reveal high rates of antimicrobial resistance in UTI pathogens, especially in non-EU countries, where Pseudomonas aeruginosa presented rates of aminoglycoside resistance as high as 72% to gentamicin, 69.2% to tobramycin and 40% to amikacin. CONCLUSIONS: Nosocomial UTI accounts for an important proportion of the workload in microbiology laboratories. A consensus on the practice and interpretation of urine cultures in Europe is needed. The levels and patterns of resistance of UTI pathogens must be a serious cause for concern and a clear reason for stricter guidelines and regulations in antimicrobial policy.

Anti-Bacterial Agents↗

PubMed2002

Sustained mental workload does not affect subsequent sleep intensity.

Mental activity is a neglected factor in sleep research. The few investigations on sleep that manipulate prior mental activity are inconclusive with respect to the possible effects of mental activity on recovery. In the present study, the effects of two levels of mental activity on subsequent sleep were studied. Thirteen male subjects (range 18-28 years) participated in one lightly and two heavily mentally strenuous conditions in a counterbalanced order. Light mental activity included 8 h of relaxed video watching. The second condition consisted of performing computer tasks involving sustained attention, memory, logical thinking and calculations for eight consecutive hours. In the third condition, the same heavy mental workload was interspersed with breaks. Subjectively, the subjects rated the condition with heavy mental activity (without breaks) as mentally more strenuous than the condition with light mental activity. Subjects were significantly less awake shortly after sleep onset in the heavy-workload condition than in the light-workload condition. There were no differences between the conditions in any of the other visually scored sleep variables. The total amount of slow wave activity (SWA) and its discharge during the night was not affected by the level of mental activity or by the presence of breaks. These findings fail to support the proposition that SWA reflects a need for sleep that accumulates at a rate depending on mental activity during prior wakefulness.

Adolescent↗

PubMed2006

Neuro-muscular fatigue and recovery dynamics following anaerobic interval workload.

The aim of this study was to determine the influence of anaerobic running on muscle contractile characteristics and voluntary muscle activation level during MVC as well as the dynamics of their recovery during a 2-hour period. Seven well-trained runners performed 5 x 300 m at submaximal velocity with a 1-minute active recovery interval between the runs. The average run velocity was 6.69 m.s(-1), which represented 77 % of their top velocity. Contractile characteristics of the vastus lateralis and activation level of quadriceps femoris muscles were measured before and immediately after the runs and within the 120-minute time interval that followed the workload. To do this we used: single twitch, low- and high-frequency electrical stimulation, maximal voluntary knee extension test, and muscle activation level test. After the exercise the maximal twitch torque (T(TW)) decreased for 28 +/- 3.7 % (p < 0.001) and torque at stimulation with 20 Hz and 100 Hz were 19.2 +/- 4.6 % (p < 0.01) and 7.5 +/- 2.3 % (p < 0.05) lower, respectively, while MVC torque and activation level remained unchanged. Subjects with higher blood lactate accumulation level showed significant decrease in the torque at low frequency stimulation (T(F20)) (r = - 0.80; p < 0.01) and T(TW) (r = - 0.92; p < 0.01). The restoration of twitch torque took a short time despite the fact that blood lactate concentration remained high. Ten minutes after the last interval run the twitch torque exceeded the pre-workload value by 11 % (p < 0.01). Potentiation lasted until the 40th min. It was concluded that fatigue after the anaerobic interval workload was peripheral in character and caused by contractile mechanisms disturbances.

Adult↗

PubMed1993

A short cycle ergometer test to predict maximal workload and maximal oxygen uptake.

In order to develop a short cycle ergometer test for the prediction of maximal oxygen uptake (VO2max) and maximal work load (Wmax) oxygen uptake, workload and heart rate data were collected in 22 subjects. In the first test the subjects cycled at two submaximal stages of 3 min each whereafter the workload was quickly (within 4 min) increased to a supramaximal level to attain the maximal heart rate. A second graded cycle test was used to compare observed Wmax and VO2max with estimated Wmax and VO2max. The means of the estimated Wmax and observed Wmax were 364.9 (SD +/- 42.4) watts and 368.8 (SD +/- 40.2) watts, respectively and the mean estimation error was -1.0% (range -7.1% to 4.4%). For 82% of the subjects the estimation error was within +/- 5%. The means of the estimated VO2max and observed VO2max were 4.49 (SD +/- 0.45) l.min-1 and 4.59 (SD +/- 0.41) l.min-1, respectively. The mean estimation error was -2.1% (range -13.8% to 5.1%). For 68% of the subjects the estimation error was within +/- 5%. It is concluded that for trained athletes the short test (8-10 min) is accurate for the estimation of Wmax and VO2max by measuring two submaximal heart rates and maximal heart rate and making use of the linear relationship between heart rate, workload and oxygen uptake.

Adult↗

PubMed2006

An evaluation of a lane support system for bus rapid transit on narrow shoulders and the relation to bus driver mental workload.

The use of dedicated bus shoulders is a key method for implementing bus rapid transit (BRT) in areas that do not have the space for additional infrastructure. However, the narrow width of the bus shoulder and the need to anticipate traffic hazards in the adjacent lane can both be significant stressors for bus drivers. Bus driver mental workload and stress in response to these conditions should be a significant concern both for operational safety and driver health. This pilot study evaluated the potential stressors of traffic density and shoulder width in the context of an express BRT service in a large US metropolitan area. In addition, the study considered the potential role of a prototype lane support system (LSS) to support vehicle control within the narrow shoulder boundaries. Ten experienced bus drivers drove an actual route with an instrumented bus equipped with and without LSS. Self-reported effort was recorded along with performance measures of speed and position control relevant to mobility and safety objectives. Bus drivers did note stressors in the BRT environment and the prototype LSS. However, the use of the shoulder during high-density traffic conditions did improve mobility. Moreover, the LSS did enhance safety on the shoulder when there was high-density traffic in the adjacent lane. However, there was no evidence that the LSS reduced bus driver workload while operating in the narrow shoulder. Future research should consider the impact of BRT operations and support systems on bus driver mental workload and stress, and support the deployment of such devices for bus operations on shoulders during high traffic volumes.

Accidents, Traffic↗

PubMed1989

Assessing the impact of computer workload on operator stress: the role of system controllability.

This paper considers the impact of working with computer-based systems in terms of mental workload and the well-being of operators. In particular, the paper focuses on issues of controllability in human-computer systems as they relate to operator stress. Through the adoption of a state control model of stress regulation, it becomes apparent that while general usability criteria are necessary for the design of controllable systems, they may not be sufficient to guarantee controllability. The implications for research and system design are discussed, with reference to the assessment of operator workload, controllability and stress. A methodology for assessing computer stress is described, based on the analysis of stressful computer-related episodes and their accompanying affective and cognitive states. This technique allows the relationship between workload and controllability to be studied in particular computer work environments, in relation to individual work goals and coping strategies.

Attitude to Computers↗

PubMed1998

Physiological workload reactions to increasing levels of task difficulty.

The sensitivity of physiological measures to mental workload was investigated in a flight simulator. Twelve pilots had to fly through a tunnel with varying levels of difficulty. Additionally, they had to perform a memory task with four levels of difficulty. The easiest memory task was combined with the easiest tunnel task and the most difficult memory task with the most difficult tunnel task. Between the tunnel tasks, subjects had to fly a pursuit task in which a target jet had to be followed. Rest periods before and after the experiment were used as a baseline for the physiological measures. Mental workload was measured with heart period, continuous blood pressure, respiration and eye blinks. Several respiratory parameters, heart rate variability, blood pressure variability and the gain between systolic blood pressure and heart period (modulus) were scored. All measures showed differences between rest and flight, and between the pursuit and the tunnel task. Only heart period was sensitive to difficulty levels in the tunnel task. Heart rate variability increased when respiratory activity around 0.10 Hz increased, which occurred often. The modulus was hardly influenced by respiration and therefore appears to be a better measure than heart rate variability. Among the respiratory parameters, the duration of a respiratory cycle was the most sensitive to changes in workload. The time in between two successive eye blinks (blink interval) increased and the blink duration decreased as more visual information had to be processed. Increasing the difficulty of the memory task led to a decrement in blink interval, probably caused by subvocal activity during rehearsal of target letters. The data show that physiological measures are sensitive to mental effort, whereas rating scales are sensitive to both mental effort and task difficulty.

Adult↗

PubMed2001

Effect of synchronized intermittent mandatory ventilation on respiratory workload in infants after cardiac surgery.

BACKGROUND: Synchronized intermittent mandatory ventilation (SIMV) is commonly used in infants and adults. However, few investigations have examined how SIMV reduces respiratory workload in infants. The authors evaluated how infants' changing respiratory patterns when reducing SIMV rate increased respiratory load. The authors also investigated whether SIMV reduces infant respiratory workload in proportion to the rate of mandatory breaths and which rate of SIMV provides respiratory workloads similar to those after tracheal extubation. METHODS: When 11 post-cardiac surgery infants aged 2-11 months were to be weaned with SIMV, the authors randomly applied five levels of mandatory breathing: 0, 5, 10, 15, and 20 breaths/min. All patients underwent ventilation with SIMV mode: pressure control ventilation, 16 cm H2O; inspiratory time, 0.8 s; triggering sensitivity, 0.6 l/min; and positive endexpiratory pressure, 3 cm H2O. After establishing steady-state conditions at each SIMV rate, arterial blood gases were analyzed, and esophageal pressure, airway pressure, and airflow were measured. Inspiratory work of breathing, pressure-time products, and the negative deflection of esophageal pressure were calculated separately for assisted breaths, for spontaneous breaths, and for total breaths per minute. Measurements were repeated after extubation. RESULTS: As the SIMV rate decreased, although minute ventilation and arterial carbon dioxide tension were maintained at constant values, spontaneous breathing rate and tidal volume increased. Work of breathing, pressure-time products, and negative deflection of esophageal pressure increased as the SIMV rate decreased. Work of breathing and pressure-time products after extubation were intermediate between those at a SIMV rate of 5 breaths/min and those at 0 breaths/min. CONCLUSION: When the load to breathing was increased progressively by decreasing the SIMV rate in post-cardiac surgery infants, tidal volume and spontaneous respiratory rate both increased. In addition, work of breathing and pressure-time products were increased depending on the SIMV rate.

Air Pressure↗

PubMed2000

The potential impact of high-quality MRI of the biliary tree on ERCP workload.

BACKGROUND: Magnetic resonance cholangiography (MRC) is a non-invasive method of imaging the biliary tree with virtually no morbidity. Endoscopic retrograde cholangiopancreatography (ERCP) has a significant morbidity, mortality and failed imaging rate. Unlike MRC, ERCP is highly dependent on the clinical team for high-quality results and minimal morbidity. MRC requires high-quality image acquisition and appropriate reconstructions, with skilled reading of the images. OBJECTIVES: To assess the impact on ERCP workload of using MRC as the initial imaging modality for the biliary tree in selected patient groups, and to assess procedure-related morbidity and mortality. METHODS: An analysis of 1078 consecutive ERCP examinations performed at our institution over the six years to 1996 has been undertaken. Complications, imaging failure rates and ERCP findings have been analysed in the different referral categories to assess the potential impact of MRC on future ERCP workload and patient outcomes. RESULTS: At our institution, if MRC had been used as the first imaging investigation in patients with abdominal pain (n = 336, with or without abnormal liver function tests but without clinical jaundice) and those with present or past acute pancreatitis (n = 101), we estimate that 83 (19%) would have needed to go on to ERCP, but 354 (81%) would not have required further invasive investigation. In these categories, this would have resulted in five patients with stones missed at MRC, but 14 extra patients with stones would have been identified whose stones would have been missed at ERCP (failed examinations). There would be an overall 33% reduction in ERCP workload and 20 serious complications related to ERCP would have been avoided. Overall 7% of patients would be subjected to both investigations. CONCLUSIONS: In the interests of efficient use of resources, minimization of patient complications and accurate identification of those requiring therapeutic ERCP, MRC should be the preferred initial investigation in selected groups of patients presently being subjected to ERCP.

Abdominal Pain↗

PubMed1983

Transient in oxygen uptake after step-increase of workload under beta-adrenoceptor blockade or vasodilation.

The effect of vasodilation (with nifedipine) or beta-adrenergic receptor blockade (with propranolol, alprenolol or metoprolol) on the rate of rise of oxygen uptake and heart rate were studied in 14 healthy subjects after a step-wise increase of workload from a light to a moderate exercise intensity. Under beta-adrenergic receptor blockade steady state oxygen uptake at both workload levels was equal to control values; heart rate went up to 111 min-1 (s.d.:15) vs 150 min-1 (s.d.:24) for the control experiments. The half-times of the oxygen uptake transient were unchanged. After vasodilation with nifedipine heart rates were higher (20% for the lower and 12% for the higher exercise level) but steady state oxygen uptake levels and rate of rise were also unchanged. It is concluded that the rate of rise of oxygen supply to working skeletal muscles after a stepwise increase of load is not reduced either by a beta-adrenergic receptor blocking drug nor by a vasodilating agent. Discomfort during exercise appears to be a subjective phenomenon related to reduced skin circulation and sweating under beta-adrenergic receptor blockade, or to headache and congestion after vasodilatory drug administration. These side-effects are not caused by a reduced oxygen supply of muscle, neither under steady state situations nor under rapid changing workload conditions.

Adolescent↗