Cardiovascular responses to occupational stress in male medical students: A paradigm for ambulatory monitoring studies.

Examined hemodynamic responses to systematic variations in occupational stress using ambulatory blood pressure monitors. Heart rate, systolic blood pressure, diastolic blood pressure, rate–pressure product, and mood states were measured before, during, and after low-stress (lecture) and high-stress (examination) work in 44 healthy White male medical students. The lecture day was characterized by stable patterns of cardiovascular activity across all 3 periods. Hemodynamic activity and reports of activation and distress were greater on the examination day than on the lecture day. Cardiovascular activity during the pre-examination period was as high as that seen during the examination period itself, indicating an anticipatory stress effect. Pressor activity decreased after the examination, although some residual chronotropic activity was seen. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impedance cardiography used to assess patterns of cardiovascular response to behavioral stressors

This paper presents two examples of how impedance cardiography may be used to interpret the hemodynamic influences on blood pressures measured during behavioral stress. In Study 1, blood pressure changes which were similar during two tasks were shown to have important differences in their cardiac output and vascular resistance components. During work on a reaction time task having aversive incentives compared with a neutral task, the blood pressure changes were seen to be associated with lowered vascular resistance and raised cardiac activity, a "fight-flight" pattern. In Study 2, blood pressure response differences between two subject groups working on an identical task were found to have blood pressure changes differing in their underlying cardiac and vascular components as measured by impedance. Such uses impedance cardiography have widespread potential application in psychophysiological research with humans.     

Pain perception and cardiovascular responses in men with positive parental history for hypertension

Evidence suggests a reduced pain sensitivity in hypertensive individuals. This study sought to extend this work to normotensive individuals with hypertensive parents. Men with a positive (PH+) or negative (PH-) parental history for hypertension rated their pain every 15 s during a 90-s hand cold pressor test and for 90 s after the cold pressor test. Systolic (SBP) and diastolic (DBP) blood pressures and heart rate were measured throughout. After the cold pressor test, the men recalled their pain using the McGill Pain Questionnaire. PH+ men showed greater SBP and DBP responses to the cold pressor test. Although pain ratings during the cold pressor test did not differ between groups, posttest reported pain receded faster in the PH+ than in the PH- men. The PH+ men also reported less total pain on the McGill. These findings support the hypothesis that risk for hypertension may be associated with attenuated pain responses to nociceptive stimuli.     

Correction to Lovallo and Pishkin.

Reports an error in the original article by William R. Lovallo and Vladimir Pishkin (Journal of Personality & Social Psychology, 1980[Jun], Vol 38[6], pp. 963-971). Lovallo and Pishkin's article carried the APA copyright notice. However, the article was prepared as part of the authors' official duties with the federal government, and therefore the copyright notice should not have appeared. (The following abstract of this article originally appeared in record 1981-12817-001.) 42 medical students, ages 20-35 yrs, were classified in either Type A or Type B groups to test D. C. Glass's (1977) assertions (a) that Type A Ss would initially react to uncontrollable noise with increased coping efforts, as indexed by improved task performance on pretreatment tasks, and (b) that following exposure they would react with decreased coping, as measured by poor performance on a final task. Type B's were predicted to perform consistently throughout. Instead, Type B's showed initial coping attempts during exposure to uncontrollability and showed decreased coping following exposure, whereas A's performed consistently throughout. It is concluded that Type A and B persons do react differently to a threat to their control of a situation, but that this experimental paradigm may lack the precision necessary to elucidate the psychological factors motivating the behavior of the coronary-prone individual. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Caffeine enhances the physiological response to occupational stress in medical students.

Tested caffeine (3.3 mg/kg) against a placebo in 20 male medical students (aged 19–31 yrs) during periods of low (no exams) vs high (final exams) work stress. On each of 8 test days, heart rate and blood pressure were measured at baseline and over a 40-min postdrug interval; immediately afterward, blood was drawn to test plasma cortisol and serum lipid concentrations. Exams increased heart rate and systolic blood pressure. Caffeine decreased heart rate and increased systolic blood pressure, diastolic blood pressure, plasma cortisol levels, and serum cholesterol levels. Caffeine effects were additive with those of exams, and together they increased the number of Ss showing systolic blood pressures in the borderline hypertensive range. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress-like adrenocorticotropin responses to caffeine in young healthy men

The effects of oral caffeine (3.3 mg/kg, equivalent to 2-3 cups of coffee) on plasma adrenocorticotropin (ACTH) and cortisol (CORT) were tested in 47 healthy young men at rest in a double-blind, placebo-controlled, crossover study. Following caffeine, ACTH was significantly elevated at all times from 30 min to 180 min, and CORT was elevated from 60 min to 120 min (Fs > or = 8.4, ps < 0.01). Peak increases relative to placebo were: ACTH, 33% (+5.2 pg/ml) and CORT, 30% (+2.7 micrograms/dl) at 60 min postcaffeine. The results suggest that caffeine can activate important components of the pituitary-adrenocortical response in humans during the resting state. Caffeine's known ability to increase CORT production appears at least partly due to an increase in ACTH release at the pituitary.     

Acute blood pressure elevations with caffeine in men with borderline systemic hypertension

It has been shown that the problem of nosocomial infections is different in each specialist hospital division, and it is important to be aware of the local situation and to identify the specific problems. In order to set up an effective prevention programme and in the setting of a general system of control of nosocomial infection, we studied the incidence of infections and correlated the pathogenic organisms appearing during hospitalization in patients admitted to our Pneumology Division and Intermediate Intensive Care Unit over a period of 12 months. A nosocomial infections incidence of 13% was observed and 75% of these were respiratory, 21% urinary and 4% other infections. Seventy two percent of pathogenic agents were Gram-negative bacilli and 28% Gram-positive cocci. The site-specific rates of infections observed are related to intrinsic (host dependent) and extrinsic (non-host-dependent) risk factors that have not been exhaustively evaluated in the present study. However, the data so far collected will allow us to redirect the resources used in the control of nosocomial infections by targeting efforts at the surveillance of better defined groups of patients and by achieving data more suitable for comparisons between hospitals.     

Hemodynamic characteristics of young men at risk for hypertension at rest and during laboratory stressors.

Examined hemodynamic activity at rest and during arithmetic and cold pressor in 105 male medical students varying in risk for hypertension. Classification into low-, moderate-, and high-risk groups was based on resting systolic blood pressure (SBP) and parental history of essential hypertension (PH). Dependent variables were SBP, diastolic BP (DBP), heart rate, and rate-pressure product (RPP). Progressively greater hemodynamic activity was seen across risk groups at rest and during the tasks. Risk groups differed significantly in SBP, DBP, and RPP at baseline and in size of response to mental arithmetic but not cold pressor. These relationships were either absent or weaker when using either risk factor alone to form risk groups. Hemodynamic reactivity to mental stress appears to be predicted better by a combination of resting SBP and hypertension than by either risk factor alone. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Performance of Type A (coronary-prone) men during and after exposure to uncontrollable noise and task failure.

42 medical students, ages 20–35 yrs, were classified in either Type A or Type B groups to test D. C. Glass's (1977) assertions (a) that Type A Ss would initially react to uncontrollable noise with increased coping efforts, as indexed by improved task performance on pretreatment tasks, and (b) that following exposure they would react with decreased coping, as measured by poor performance on a final task. Type B's were predicted to perform consistently throughout. Instead, Type B's showed initial coping attempts during exposure to uncontrollability and showed decreased coping following exposure, whereas A's performed consistently throughout. It is concluded that Type A and B persons do react differently to a threat to their control of a situation, but that this experimental paradigm may lack the precision necessary to elucidate the psychological factors motivating the behavior of the coronary-prone individual. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cardiac adaptation to increased systemic blood pressure in borderline hypertensive men

Two women, aged 28 and 32, presented with primary infertility and severe dysmenorrhea. The younger woman developed recalcitrant and recurrent firm vaginal, cervical and possibly endometrial lesions over a period of six years; the older patient had similar material in the cervix, endometrium and a fallopian tube. The lesions were composed of amorphous eosinophilic hyaline or necrotic material, shown by histochemical and immunoperoxidase stains to be partly fibrin. Pathologic examination showed that the lesions were similar to those of ligneous (pseudomembranous) conjunctivitis, a rare disease that may occasionally affect the lower female genital tract. However, neither patient had eye disease, and ligneous conjunctivitis has not previously been reported to involve the upper genital tract. Endometrial and tubal involvement could readily explain primary infertility and dysmenorrhea in these patients.