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| 2. |
- Herlitz, Johan, et al.
(author)
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Effects of metoprolol CR/XL on mortality and hospitalizations in patients with heart failure and history of hypertension.
- 2002
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In: Journal of Cardiac Failure. - : Churchill Livingstone. - 1071-9164 .- 1532-8414. ; 8:1, s. 8-14
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Journal article (peer-reviewed)abstract
- BACKGROUND: We describe the effect of controlled-release/extended-release (CR/XL) metoprolol succinate once daily on mortality and hospitalizations among patients with a history of hypertension complicated by chronic systolic heart failure. METHODS AND RESULTS: We enrolled 3,991 patients with chronic heart failure of New York Heart Association functional class II-IV with an ejection fraction of < or = 0.40, stabilized with optimum standard therapy, in a double-blind randomized placebo-controlled study. A total of 1,747 patients (44%) had a history of hypertension; 871 were randomized to receive metoprolol CR/XL and 876 to receive placebo. Treatment with metoprolol CR/XL compared with placebo resulted in a significant reduction in total mortality (relative risk [RR], 0.61; 95% confidence interval [CI], 0.44-0.84; P =.0022), mainly because of reductions in sudden death (RR, 0.51; 95% CI, 0.33-0.79; P =.0022) and mortality from worsening heart failure (RR, 0.49; 95% CI, 0.25-0.99; P =.042). Total number of hospitalizations for worsening heart failure was reduced by 30% in the metoprolol CR/XL group compared with placebo (P =.015). Metoprolol CR/XL was well tolerated: 12% fewer patients withdrew from study medication (all-cause) compared with placebo (P =.048). CONCLUSIONS: A subgroup analysis of MERIT-HF shows that patients with heart failure and a history of hypertension received a similar benefit from metoprolol CR/XL treatment as all patients included in the total study.
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| 3. |
- Andersson, Bert, 1952, et al.
(author)
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Dose-related effects of metoprolol on heart rate and pharmacokinetics in heart failure.
- 2001
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In: Journal of cardiac failure. - 1071-9164. ; 7:4, s. 311-7
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Journal article (peer-reviewed)abstract
- The pharmacokinetics and pharmacodynamics of immediate-release (IR) metoprolol, 50 mg 3 times daily, were compared with those of different doses of controlled-release/extended-release metoprolol (CR/XL) given once daily.Fifteen patients with chronic heart failure were randomized to a 3-way crossover study to receive metoprolol IR 50 mg 3 times daily, CR/XL 100 mg once daily, and CR/XL 200 mg once daily for 7 days. On the seventh day of each treatment, serial plasma samples were drawn and standardized exercise tests and a 24-hour Holter recording were performed. Metoprolol IR 50 mg produced peak plasma levels comparable to those observed for CR/XL 200 mg (285 v 263 nmol/L). The difference in mean 24-hour heart rate between CR/XL 100 mg and IR 50 mg was 1.0 bpm (95% confidence interval [CI]), -2.9 to 4.9; NS) compared with -3.8 bpm (95% CI, -7.6 to -0.04; P = .048) between CR/XL 200 mg and IR 50 mg. Submaximal exercise heart rate was lower for patients receiving CR/XL 200 mg than those receiving IR 50 mg. No difference in tolerance or exercise performance was observed between treatment regimens.Peak plasma levels produced by metoprolol 200 mg CR/XL were similar to those of 50 mg IR. Metoprolol CR/XL 200 mg was associated with a more pronounced suppression of heart rate than metoprolol IR 50 mg. It is suggested that patients can safely be switched from multiple dosing of metoprolol IR 50 mg to a once-daily dose of metoprolol CR/XL.
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| 4. |
- Andersson, Bert, 1952, et al.
(author)
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N-terminal proatrial natriuretic peptide and prognosis in patients with heart failure and preserved systolic function.
- 2000
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In: Journal of cardiac failure. - : Elsevier BV. - 1071-9164. ; 6:3, s. 208-13
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Journal article (peer-reviewed)abstract
- Congestive heart failure and preserved left ventricular systolic function is a common clinical condition. Although the prognosis in this type of heart failure is better in comparison to systolic dysfunction, prognostic markers to evaluate long-term outcome are lacking. The atrial peptide, N-terminal proatrial natriuretic peptide (proANP), has been shown to predict survival in patients with systolic dysfunction. We intended to evaluate the predictive capability of N-terminal proANP in patients with preserved systolic function (ejection fraction [EF] > or = 0.40).A clinical and echocardiographic examination was performed in 149 patients with idiopathic heart failure from a population-based cohort, and 84 patients were identified to have preserved systolic function, with an EF of 0.40 or greater. The patients were followed up during 7 years with regard to symptoms, treatment, hospitalization, and survival. The patients with normal EFs had greater plasma concentrations of N-terminal proANP compared with a control group, and N-terminal proANP level was an independent predictor of mortality (risk ratio, 2.44; 95% confidence interval, 1.28 to 4.67; P = .007). In addition, a high concentration of N-terminal proANP predicted an increased rate of hospitalization (50% for a level > 1,200 pmol/L versus 19% for a level < or = 1,200 pmol/L; P = .046) and a greater future dosage of diuretic (127+/-102 vs 51+/-39 mg; P = .007).N-terminal proANP level was an independent marker of increased mortality and morbidity in patients with preserved systolic function, whereas EF was not usable in this regard. It is suggested that this peptide could be used to identify clinically relevant left ventricular dysfunction in patients with EFs within the normal range.
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| 5. |
- Dekker, Sidney
(author)
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Human factors in certification.
- 2003
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In: The International journal of aviation psychology. - 1050-8414 .- 1532-7108. ; 13:1, s. 89-93
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Review (other academic/artistic)
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| 6. |
- Dekker, Sidney
(author)
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Illusions of explanation : A critical essay on error classification
- 2003
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In: The International journal of aviation psychology. - 1050-8414 .- 1532-7108. ; 13:2, s. 95-106
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Journal article (peer-reviewed)abstract
- Error classification methods are used throughout aviation to help understand and mitigate the causes of human error. However, many assumptions underlying error classification remain untested. For example, error is taken to mean different things, even within individual methods, and a close mapping is uncritically presumed between the quantity measured (errors) and the quality managed (safety). Further, error classifications can deepen investigative biases by merely relabeling error rather than explaining it. This article reviews such assumptions and proposes alternative solutions.
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| 7. |
- Ghali, J. K., et al.
(author)
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Consistency of the beneficial effect of metoprolol succinate extended release across a wide range dose of angiotensin-converting enzyme inhibitors and digitalis
- 2004
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In: J Card Fail. - 1071-9164. ; 10:6, s. 452-9
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Journal article (peer-reviewed)abstract
- BACKGROUND: The effects of beta-blockade with different extent of angiotensin-converting enzyme inhibitors (ACEI) and digitalization are unknown. To assess the effect of metoprolol succinate controlled release/extended release (CR/XL) combined with high versus low doses of ACEI and digitalis, we analyzed data from The Metoprolol CR/XL Randomized Intervention Trial in Chronic Heart Failure (MERIT-HF) in which patients with heart failure and left ventricular ejection fraction < or =40% were randomized to metoprolol CR/XL versus placebo. METHODS AND RESULTS: Outcome was analyzed separately for those on a low dose (< or =median) of the ACEI or digitalis versus high dose (> median). The mean dose of ACEI in the high-dose group (n = 1457) was 3 times higher than that in the low-dose group (n = 2094). Mortality was reduced to a similar extent in the high- and low-dose ACEI subgroups (RR = .69 versus .64, respectively). Corresponding figures for combined mortality/all hospitalization and for mortality/hospitalization for heart failure were .85 versus .83, and .70 versus .68, respectively. Likewise, reduction in total mortality with metoprolol CR/XL was similar in patients receiving no digitalis (n = 1447; RR = .56), low dose (n = 1122; RR = .71), or high dose (n = 1421; RR = .71). CONCLUSION: This analysis of MERIT-HF demonstrates consistent and similar improvement in outcome of patients receiving metoprolol CR/XL when combined with either a high or low dose of an ACEI or digitalis, or no digitalis at all. Thus regardless of ACEI and digitalis dose and whether patients are treated with digitalis or not, it is very important to add a beta-blocker to the existing heart failure therapy. beta-blockers should not be withheld until target doses of ACEI have been achieved.
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| 9. |
- Magnusson Nählinder, Staffan, 1971-
(author)
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Similarities and differences in psychophysiological reactions between simulated and real air-to-ground missions
- 2002
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In: The International journal of aviation psychology. - : Taylor & Francis. - 1050-8414 .- 1532-7108. ; 12:1, s. 49-61
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Journal article (peer-reviewed)abstract
- This study examines the similarities and differences in psychophysiological reactions in simulated and real flight. Five fighter pilots from the Swedish Air Force participated in the study, flying the same type of mission in a simulator and in real flight. Each pilot flew the same mission 3 times in the simulator and later 3 times in real flight. The pilots' heart rate, heart rate variability, and eye movements were continuously measured. Analyses of these data indicate that the pilots' psychophysiological reactions are very analogous in the simulator and in real flight.
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| 10. |
- Rigner, J, et al.
(author)
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Sharing the burden of flight deck automation training
- 2000
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In: The International journal of aviation psychology. - 1050-8414 .- 1532-7108. ; 10:4, s. 317-326
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Journal article (peer-reviewed)abstract
- Flight deck automation has generated new training requirements, most of which have been absorbed by in-house airline training, in particular, aircraft transition training. This leaves little room for learning about how human roles have shifted in automated cockpits or how the distinction between technical and nontechnical skills has become blurred when managing the flight path of an automated aircraft. This article explores how overall pilot training quality, efficiency, and effectiveness would benefit from pulling automation training forward into the pilot training curriculum, reducing the burden carried mainly by transition training today. This article examines various stages of pilot training (including ab initio, multicrew cooperation, and crew resource management training) and lays out the opportunities and obstacles they contain for the integration of flight deck automation. In conclusion, airlines themselves can play a constructive role by specifying what kinds of automation learning requirements earlier pilot training stages should cover, and by sharing their automation philosophies and actively taking part in the design of the preairline training. Such participation from an airline can help achieve appropriate knowledge and attitudes toward automation among its future pilots.
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| 11. |
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| 12. |
- Svensson, EAI, et al.
(author)
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Psychological and psychophysiological models of pilot performance for systems development and mission evaluation
- 2002
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In: The International journal of aviation psychology. - 1050-8414 .- 1532-7108. ; 12:1, s. 95-110
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Journal article (peer-reviewed)abstract
- The purpose of our study was to analyze the effects of mission complexity on pilot mental workload, situational awareness, and pilot performance and to develop models by means of structural equation modeling. Earlier studies indicate that mission complexity affects mental workload and that mental workload affects situational awareness, which, in turn, affects pilot performance. In the first phase of this study, 20 fighter pilots performed 150 missions. In the second phase, 15 pilots performed 40 simulated missions. The pilots answered questionnaires on mission complexity, mental workload, mental capacity, situational awareness, and performance. During the simulated missions we measured eye fixation rate, heart rate, and blink rate. Model analyses show that mission complexity affects workload and that workload affects situational awareness and performance. Significant relationships occur between heart rate and rated workload, mental capacity, situational awareness, and performance. Model analyses show a workload factor combining psychological and physiological aspects and a performance factor combining situational awareness and pilot performance. Significant relationships occur among heart rate, eye fixation rate, and blink rate.
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| 13. |
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