Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “work intensity”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,009 records · Page 56Linked to original sources
PubMed2001

La partera profesional: articulating identity and cultural space for a new kind of midwife in Mexico.

This article documents the emergence of a new kind of midwife in Mexico, the thoroughly postmodern partera profesional. It traces the transnational conjunctures that facilitated her creation, illustrates aspects of her philosophy and praxis, and probes her ongoing articulations of identity. These women, who are of diverse sociocultural backgrounds, initially sought training from American direct-entry midwives in the independent out-of-hospital midwifery model; now, they are adapting that model to the situation in Mexico. Through their own practices, through intensive liaison work with traditional midwives, and through organizing national midwifery conferences and meetings, they are creating midwifery as both incipient profession and nascent social movement. Some of them operate outside the medical system while others are carving a niche within it. The mere existence of these self-consciously activist midwives constitutes a critique of monological Mexican medicine and its high cesarean rates; however, these women face a long struggle to define their identities, legalize their practices, and generate a sustainable space within the emergent Mexican technocracy. To their intense dismay, this struggle must take place within the context of the escalating disappearance of the traditional midwives whom they seek to support. The tension they feel between their desire to preserve traditional midwifery and their desire to create professional midwifery is a recurrent theme. These goals alternately complement and conflict with one another, yet both are central to the partera profesional's ongoing efforts at identity articulation.

Attitude of Health Personnel↗
PubMedDate not supplied

Nurses and physicians evaluate their intensive care experiences.

OBJECTIVE: Analysis of the evaluation of intensive care experiences of nurses and physicians in relation to their educational background and degree of professionalization. DESIGN: Cross-cultural, qualitative study design: German nurses and physicians and American nurses. SETTING: German medical intensive care unit (nine beds), German surgical intensive care unit (six beds), and an American medical-surgical intensive care unit (16 beds). SUBJECTS: Thirteen German nurses (eight women, five men) of a medical intensive care unit, six German nurses (five women, one man) of a surgical intensive care unit, nine German physicians of a medical intensive care unit (two women, seven men), and 13 American nurses of a medical-surgical intensive care unit (10 women, three men). METHODS: The interviewing technique by the method of Role Repertory Grid Test by G.A. Kelly. We focused on important job experiences in intensive care and the remembered evaluation of these experiences. RESULTS: The reported experiences of intensive care unit nurses and physicians show negative as well as positive appraisals. No correlation can be shown between negative appraisals and the degree of professionalization or training of German nurses and physicians, and American nurses, respectively. The qualitative-content analysis of positively appraised experiences does indicate, for all four studied groups, that even primarily so-called "positive" experiences are closely connected with negative aspects and connotations. CONCLUSIONS: The results indicate that nurses and physicians experience intensive care work with extreme ambivalence. To be content with and successful on the job it appears necessary to develop a high level of ambivalence. From a methodologic point of view, the advantages of the interviewing technique (Role Repertory Grid) are discussed.

Adaptation, Psychological↗
PubMed1992

[Work history, health conditions and hearing loss of Ishigaki fishermen].

Based on our previous health survey among Ishigaki fishermen in 1979, this study aimed at clarifying the relations of their work histories to physical characteristics, physiological functions, blood conditions and hearing levels. Medical examination was conducted in 1987 on 118 fishermen inclusive of 33 followed-up fishermen, and in 1989 noise-level and noise-induced temporary threshold shift of hearing was measured for different fishing methods. The results were as follows; 1) Fishing history was not specifically associated with any physical characteristics. 2) High HDL cholesterol, which was observed among divers using diving apparatus, was considered to be a survival effect for divers, since HDL cholesterol is amplified by intensive muscle work. 3) Abnormalities of ECG except for a high R wave were notably observed among the divers, who once changed from unassisted diving to diving with apparatus and then to fishing lines. The main reason for switching jobs was claimed to be caisson disease, and it was suggested that diving with apparatus was related to a high risk of health hazards in the central nervous system and/or respiro-circulatory system. 4) Acoustic acuity greatly declined with aging, and which was commonly observed in groups with different work histories. By way of explanation, exposure to ship engine sounds during daily travelling was the most likely cause. It was also revealed that several hours' exposure to the engine sounds was needed to detect a temporary threshold shift of hearing before and after work.

Cardiovascular Diseases↗
PubMed1992

Metabolic response of horses to a high soluble carbohydrate diet: effects of low-intensity submaximal exercise and sodium bicarbonate supplementation.

Four mares fed a low fiber, high soluble carbohydrate diet were used in a crossover design to evaluate the effects of dietary sodium bicarbonate (NaHCO3) supplementation during daily low-intensity submaximal working conditions. Mares were fed the diet at 1.7 times the maintenance energy requirement for mature horses at work. The horses tolerated the diet well and had no clinical abnormalities. Resting venous blood bicarbonate (HCO3), standard HCO3, and base excess (BE) concentrations significantly (P less than 0.05) increased with NaHCO3 supplementation, but no significant changes in resting venous blood pH or carbon dioxide tension (PCO2) were recorded. Venous blood HCO3, standard HCO3, BE, hemoglobin, and heart rate were significantly (P less than 0.05) increased and plasma lactate concentration was significantly (P less than 0.05) decreased in the control horses and in the horses given the NaHCO3 supplement during low-intensity submaximal exercise. There were no significant changes in venous blood pH, PCO2, or plasma protein concentration with exercise. Venous blood HCO3, standard HCO3, and BE concentrations were significantly (P less than 0.05) greater during submaximal exercise in horses given the NaHCO3 supplement. There were no significant differences in plasma lactate or total protein concentrations, blood pH, PCO2, or hemoglobin concentration between the 2 groups during exercise.

Acid-Base Equilibrium↗
PubMed2005

Outcomes-based funding for vocational services and employment of people with mental health conditions.

OBJECTIVE: This study explored the likelihood of and identified the factors related to securing and sustaining jobs for people with psychiatric disabilities in New York State who received vocational services through an outcomes-based reimbursement program. METHODS: Quantitative and qualitative data were collected over two years to characterize placement and retention through the performance-based contracting demonstration. Seven social service agencies located statewide were contracted by the New York State Office of Mental Health to provide vocational services to people with mental health conditions through the performance-based contracting milestone structure, which established incremental steps toward the goal of sustained integrated competitive employment at which providers were reimbursed. Intake was continuous throughout the demonstration period, from December 2000 to December 2002. Key outcomes included placement in employment, time to placement, and job retention. RESULTS: Data were examined for the 171 participants who were still active in the demonstration at the end of the study period. A total of 108 participants (63 percent) were successful in securing jobs. Among those placed, 79 (73 percent) retained work at the end of the demonstration, a rate comparable to other best-practice models. Factors related to these outcomes included number of provider hours spent assisting consumers weekly, length of time to placement, consumer enrollment in the state's rehabilitation services program, and quality of the jobs developed. CONCLUSIONS: Outcomes funding was associated with successful employment for people with psychiatric disabilities. The performance-based funding structure may encourage providers to work more intensively with consumers early in the placement process, find jobs that consumers want to keep, and coordinate more effectively with the state rehabilitation agency.

Adult↗
PubMed1981

The effects of a glycogen-loading regimen on the capacity to perform anaerobic exercise.

The effect of a pattern of exercise and dietary modifications, which was designed to produce alterations in the muscle glycogen content, on the capacity to perform anaerobic exercise was investigated. Six young male subjects worked to exhaustion on a bicycle ergometer at a supramaximal work load equivalent to 104 +/- 5% of VO2max after a normal diet, after a carbohydrate (CHO)-free diet following prolonged exhausting exercise, and after a high-CHO diet. This regimen has previously been shown to cause changes in the glycogen content of the working muscle. Mean work time for subjects on the first test was 4.87 +/- 1.07 min (mean +/- SD). After the low-CHO diet, the time for which work could be maintained was reduced in an increase to 3.32 +/- 0.93 min, whereas administration of the high-CHO diet resulted in an increase to 6.65 +/- 1.39 min. The resting blood lactate concentration was lower than normal following the low-CHO diet and higher than normal following the high-CHO diet. Post exercise blood lactate concentrations reached a peak between 2 and 6 min after exhaustion and again were lower (8.60 +/- 1.58 mmol/l) after the low-CHO diet and higher (12.86 +/- 1.42 mmol/l) after the high-CHO diet than after performing the same intensity of work to exhaustion on a normal diet (11.66 +/- 1.16 mmol/l). The rate of lactate accumulation appeared to be approximately the same during exercise under all three dietary conditions. If this is the case, it suggests that the alterations in endurance capacity do not result from changes in the rate of anaerobic glycolytic energy production, but possibly from a change in the total capacity of the system.

Adult↗
PubMed2002

How clinicians in neonatal care see the introduction of neonatal nurse practitioners.

UNLABELLED: The aim of this study was to investigate the views of UK clinicians in neonatal care who were working with nurses trained as neonatal nurse practitioners (NNPs). A questionnaire survey was used with a total sample of senior clinicians in the 66 neonatal units with one or more qualified NNPs. The main outcome measures were type and frequency of response, and similar data from NNPs were used to make comparisons. Data were returned from 57 of the 66 clinicians contacted (86%). NNP clinical practice as perceived by them was largely similar to that recorded by NNPs, though the clinicians expected more NNP involvement in some procedures (inserting central venous lines, umbilical arterial catheters, chest drains and peripheral arterial cannulae) than was actually found. Perceptions of the NNP role were similar, though the clinicians were significantly less likely to see taking a case-load, conducting a ward round, accepting outside referrals and taking charge of emergency transfers as integral elements. Reflections on the utilization of NNPs in neonatal care and the impact on junior medical staff education referred to NNPs filling gaps, a reduction in the intensity of work, improvements in training and in the quality of care. CONCLUSION: The introduction of NNPs is seen positively from the perspective of clinicians working alongside them in neonatal care. The development of similar models of care in countries where the introduction of NNPs is being considered is likely to be similarly supported.

Attitude of Health Personnel↗
PubMed1994

Clinical relevance of basic research in peptic ulcer disease.

Historically, the interplay between basic research and clinical observation has been essential in the development of new therapies for peptic ulcer disease. That histamine is an important regulator of acid secretion emerged from basic research, followed by the clinical development and use of the H2-receptor antagonists. Basic research contributed again by defining the importance of H+/K(+)-ATPase in acid secretion, resulting in a new class of useful antisecretory agents. Basic studies also gave us prostaglandins (PG) as mucosal protective agents. As 'replacement' therapy, clinicians have found that PG are protective against non-steroidal anti-inflammatory drug (NSAID)-induced gastric ulcer (GU). Physiologic studies established that somatostatin is a potent inhibitor of acid secretion, providing the stimulus for clinical studies in Zollinger-Ellison (ZE) Syndrome with a synthetic analog (octreotide). Work on isoforms of the parietal cell gastrin receptor has shown differences in the cytoplasmic domain for G protein coupling. This will aid in understanding how receptor changes and coupling to second messengers relate to the aetiopathogenesis of abnormal gastric secretion. Immune cells express mRNA for histamine, muscarinic and gastrin receptors, supporting the relevance of mucosal immunology in gastroenterology, especially in light of Helicobacter pylori-associated gastritis and ulcers. Lab research has revealed a potential role for basic fibroblast growth factor (bFGF), and another endogenous peptide BPC-15, in ulcer healing. The former substance may be responsible for the antiulcer efficacy of sucralfate. Intensive basic work on how H. pylori organisms attach to gastric cells and initiate inflammatory reactions in the mucosa will have unquestionable impact on improved therapy for peptic ulcer disease.

Animals↗
PubMed2000

Negotiating natural death in intensive care.

Recent empirical evidence of barriers to palliative care in acute hospital settings shows that dying patients may receive invasive medical treatments immediately before death, in spite of evidence of their poor prognosis being available to clinicians. The difficulties of ascertaining treatment preferences, predicting the trajectory of dying in critically ill people, and assessing the degree to which further interventions are futile are well documented. Further, enduring ethical complexities attending end of life care mean that the process of withdrawing or withholding medical care is associated with significant problems for clinical staff. Specific difficulties attend the legitimation of treatment withdrawal, the perceived differences between 'killing' and 'letting die' and the cultural constraints which attend the orchestration of 'natural' death in situations where human agency is often required before death can follow dying. This paper draws on ethnographic research to examine the way in which these problems are resolved during medical work within intensive care. Building on insights from the literature, an analysis of observational case study data is presented which suggests that the negotiation of natural death in intensive care hinges upon four strategies. These, which form a framework with which to interpret social interaction between physicians during end of life decision-making in intensive care, are as follows: firstly, the establishment of a 'technical' definition of dying--informed by results of investigations and monitoring equipment--over and above 'bodily' dying informed by clinical experience. Secondly, the alignment of the trajectories of technical and bodily dying to ensure that the events of non-treatment have no perceived causative link to death. Thirdly, the balancing of medical action with non-action, allowing a diffusion of responsibility for death to the patient's body; and lastly, the incorporation of patient's companions and nursing staff into the decision-making process.

Attitude to Death↗
PubMedDate not supplied

Nurses' knowledge of heart failure education topics as reported in a small midwestern community hospital.

Recurrent heart failure (HF) is the most common cause for readmission of elderly patients with HF. Patient education is an essential component of care for these patients. Healthcare providers must have a sufficient knowledge base to facilitate this education. This study aims to describe nurses' knowledge of HF self-management education principles. Fifty-one nurses working in a small Midwestern community hospital completed a 20-item true or false written survey developed by Albert et al (Heart Lung. 2002;31:102-112) to assess their knowledge of 5 areas of HF self-management. The sample included 14 nurses working in an intensive care unit and 41 nurses working on a general medical unit, all routinely providing care to patients with HF. The mean (+/-SD) HF self-care knowledge score was 14.6 +/- 2 (range = 9-19). There was no statistical difference in mean score between intensive care unit (14.7 +/- 1.6) and floor (14.5 +/- 2.1) nurses. Correct responses to individual survey items ranged from 20% to 100%; 6 questions resulted in mean scores >90% correct, 9 questions had mean scores between 70% and 90% correct, and 5 questions had mean scores <70% correct. Most respondents (90%) answered 6 questions correctly, but on 9 questions, 70% and 90% answered correctly. On 5 questions, less than 70% answered them correctly. Two questions (need for daily weight monitoring when asymptomatic and the importance of notifying the doctor of new onset or worsening of fatigue) were answered correctly by all participants. Subject areas of frequently missed questions were the use of nonsteroidal anti-inflammatory drugs, use of potassium-based salt substitutes, assessment of weight results, and physician notification of asymptomatic low blood pressure and momentary dizziness when rising. These results suggest that nurses working in a small community hospital may not be sufficiently knowledgeable in HF management principles. Additional emphasis on HF educational principles may improve the quality of patient education. One suggested intervention is to provide ongoing education for nurses regarding HF management.

Aged↗
PubMed2005

Challenging the representations of cancer pain: experiences of a multidisciplinary pain management group in a palliative care unit.

OBJECTIVE: This article describes how a Multidisciplinary Pain Management Group was set up in a palliative care unit, and outlines the ways that the group works with different patients. We place these comments in the context of the wider representations of pain. METHODS: Our observations of patients seen by the multidisciplinary team. RESULTS: We tentatively propose that where the patient's pain has certain characteristics it may require a different approach. Patients who are older, with a lengthy treatment history, may require a different input than younger patients, who may have a number of factors that further complicate their experience of pain. We use our extensive experience with mesothelioma patients to draw a further important distinction between this patient group and other patients. SIGNIFICANCE OF RESEARCH: Our observations suggest the need to allow sufficient time for intensive psychological work to be done with mesothelioma patients in order for pharmacological interventions to be effective.

Attitude of Health Personnel↗
PubMed1993

Assessing the implementation of physician-payment reform.

BACKGROUND: The Medicare program fundamentally changed its system of payment for physicians' services in 1992. Controversy over the new Medicare fee schedule has focused on three issues: the adequacy of the conversion factor used to translate resource-based relative-value units into fees; the ability of the new payment system to capture differences in work between surgeons and physicians in other specialties; and the allocation of practice expenses across services. METHODS: Using a standard service in each specialty, we developed simulation methods to assess the implementation of physician-payment reform. With these methods we calculated the potential net income for each specialty, as generated by different payment scenarios, including the Medicare fee schedule. RESULTS: We found that Medicare's current monetary-conversion factor yields an unreasonably low level of income for most specialties. Furthermore, the Medicare fee schedule misallocates practice expenses; invasive services are reimbursed for more than actual expenses, and medical services are reimbursed for less. Thus, physicians continue to be paid more generously for invasive services. Finally, the Medicare fee schedule does recognize the wide differences in the intensity of work performed by physicians in various specialties. CONCLUSIONS: The misallocation of practice expenses in the Medicare fee schedule results in serious underpayment for medical services. We think it likely that physicians compensate by performing more lucrative services, such as diagnostic tests. Even if legislation is passed to deal with the misallocation of expenses, the current conversion factor still produces unreasonably low levels of payment overall, which could dissuade those considering a career in medicine from entering the field. Finally, the simulation method we developed can be used as a tool for fee negotiations.

Economics, Medical↗
PubMed1995

The management of bereavement on intensive care units.

OBJECTIVE: To investigate the management of the bereaved on Intensive Care Units (ICU) throughout the United Kingdom, and to identify inadequacies that may exist either in the provision of staff training in dealing with bereavement or in the facilities or support available for the bereaved. DESIGN: Questionnaires were sent to the senior nurse and senior doctor in all general ICUs with more than four beds nationwide. The questions asked about nursing and medical practice around the time of a patient's death, as well as about staff attitudes towards, and training in, dealing with bereavement and the support they received for this role. RESULTS: We obtained a 68% (293/430) response rate. Most ICUs had facilities for relatives, but little for the specific needs of the bereaved. Only 6% of doctors and 21% of nurses had training in dealing with bereavement and grieving. A staff support group was available in 23% of ICUs, and 75% of the remainder thought it would be useful to have one. Lack of staff training and poor facilities for relatives were identified as the major concerns of ICU staff. CONCLUSION: Many doctors and nurses working in Intensive Care Units feel inadequately trained to deal confidently with the bereaved. A minority of ICUs have support mechanisms available for their staff, inspite of the perceived need for them. Furthermore, many ICU staff feel the facilities they are able to offer the bereaved are inadequate. We have identified the major inadequacies and the needs of ICU staff for improved training. Meeting these needs would play a significant role not only in reducing staff stress but also minimising the morbidity in surviving relatives.

Bereavement↗
PubMed1981

[Measurement and hygienic evaluation of electromagnetic fields in the environment of diathermy, welding machines and induction heaters].

Measurements of electromagnetic field intensity at work-stations, as well as in the environment of 36 induction heaters, 24 welders and 6 diathermies have been taken. Maximum values of field E intensity at the work-stations with induction heaters ranged from below 2 V/m to 96 V/m, and for field H -- from below 0.5 A/m to 8.2 A/m. Maximum values of field E intensity at the work-stations with welders ranged from 25 V/m to 480 V/m. And Maximum values of field E with diathermy exceeded 300 V/m near electrodes. At the work-station of medical staff operating diathermy, the field intensity values ranged from 5.1 to 16 V/m. Basing on the obtained values of the e-m intensity at work-stations and in the environment of the mentioned instruments, protective zones ranges have been determined: intermediate, weerning and dangerous. In addition, effective e-m field exposure duration, at specific instruments, has been determined.

Diathermy↗
PubMed2005

An 18-month follow-up study on vibrotactile sense, muscle strength and symptoms in computer users with and without symptoms.

OBJECTIVES: The aim was to explore whether symptoms, sensory perception and muscle strength among computer users with and without symptoms in forearm or hand had changed after 18 months. METHODS: Twenty-six out of 30 females, experienced computer users, from a baseline study participated in the follow-up. In addition, five control subjects participated. The subjects completed a questionnaire regarding exposure to computer work, prevalence and severity of symptoms, health status and physical activity. Perceived thresholds for vibration were measured twice with 3 h in between on the right hand on four different sites innervated by the radial, median or ulnar nerve. Furthermore, sensory perception was measured on the left hand on two sites innervated by the median and ulnar nerve, respectively. Skin temperature was measured at each site prior to sensory perception measurements. Maximal handgrip strength and maximal pinch-grip strength were measured for both hands. RESULTS: Eighty-three percent of the subjects who had symptoms at baseline still had symptoms and 21% of the subjects who did not have symptoms at baseline experienced symptoms at follow-up. The first and the second sensory perception measurement were highly correlated. Vibrotactile sensory threshold representing the radial nerve was increased since baseline among the subjects who originally had symptoms. At follow-up, the vibrotactile sense for the computer users who reported symptoms in forearm or hand at baseline was deteriorated for the sites representing the median, ulnar and radial nerves compared to the control group. Among the original symptom free subjects with intensive computer work increases in vibrotactile perception thresholds were found for the sites representing the median and ulnar nerves. Handgrip muscle strength remained unchanged for all groups. CONCLUSIONS: The study indicates that sensory dysfunctions as well as symptoms in forearm and hand among computer users to a high degree are persistent. Muscle strength seems to be well maintained.

Adult↗
PubMed2002

The relationships between aerobic fitness, power maintenance and oxygen consumption during intense intermittent exercise.

This study examined the relationships between VO2max, power maintenance and oxygen consumption during intense intermittent work. Female recreational soccer players were assigned to either a low aerobic power group (LOW, n = 6, mean (SD) VO2max = 34.4 (2.4) mL.kg(-1)min(-1) or to a moderate aerobic power group (MOD, n = 7, VO2max = 47.6 (3.8) mL.kg(-1).min(-1)). VO2 was measured while subjects performed 10 6-s all-out sprints (30-s passive recovery) on a Monark cycle ergometer. LOW and MOD subjects generated similar peak 6-s power (p = .58) but MOD had a smaller decrement in power (% DO) over the 10 sprints (LOW vs MOD: 18.0 (7.6) vs 8.8 (3.7) % DO, p = .02). The MOD group also consumed significantly more oxygen than LOW in 9 of the 10 sprint-recovery cycles (p < .05). Significant relationships were seen between VO2max and the aerobic response to the sprint-recovery series (r = .78, p =.002) as well as between VO2max and % DO (r = -.65, p = .02), while a non-significant relationship was seen between the oxygen consumed during the sprint-recovery cycles and % DO (r = -.41, p = .16). Thus, VO2max appears to be related to both an increased aerobic contribution to sprint-recovery bouts and the enhanced ability of the MOD group to resist fatigue during intense intermittent exercise.

Adult↗
PubMed1998

Analysis and Transition Probabilities for the Na2 B1Piu --> X1Sigma+g System Using as Excitation the 4727-Å Ar+ Laser Line.

The fluorescence spectrum of Na2 induced by the 4726.87 Å line of an Argon ion laser has been analyzed with special emphasis on determination of accurate relative intensities. This work extends previous observations on Na2 by using this excitation line. We have observed eight fluorescence series for the B1Piu --> X1Sigma+g band system corresponding to the excitation transitions v' = 9, J' = 38 <-- v" = 1, J" = 37; v' = 14, J' = 46 <-- v" = 4, J" = 47; v' = 14, J' = 81 <-- v" = 3, J" = 80; v' = 15, J' = 65 <-- v" = 4, J" = 66; v' = 12, J' = 36 <-- v" = 3, J" = 36; v' = 12, J' = 40 <-- v" = 3, J" = 39 v' = 17, J' = 45 <-- v" = 6, J' = 45 and v' = 18, J' = 63 <-- v" = 6, J" = 63. The seven latter series are reported for the first time. Optically pumped laser transitions obtained in Na2 vapor by using this excitation wavelength have been assigned. The radiative transition probabilities for the observed fluorescence series were calculated using hybrid potential energy curves for the B1Piu and X1Sigma+g states constructed up to last vibrational levels and an ab initio transition dipole moment function. Radiative lifetimes for the rovibrational levels of the upper states pumped by the laser line have also been calculated. The transition probabilities and lifetimes agree with the corresponding observed measurements, usually within the experimental uncertainty. From the rotational satellite structure with DeltaJ' = +/-1 and +/-2 of some bands, for the most intense fluorescence series, collision-induced transition rates and average cross sections have been obtained. Copyright 1998 Academic Press.

Journal Article↗
PubMed2004

Effect of short-term treatment with low dosages of the proton-pump inhibitor omeprazole on serum chromogranin A levels in man.

BACKGROUND: Measurement of chromogranin A (CgA) levels in blood can be used to monitor neuroendocrine tumors (NETs). CgA levels may also be elevated in several other endocrine and non-endocrine diseases. It is well known that drugs affecting acid gastric secretion can increase gastrin. Proton-pump inhibitors are extensively used but only a few data have been reported on their effects on CgA secretion. DESIGN: The aim of the study was to evaluate the short-term effect of low dosages of omeprazole (OM) on CgA levels and to sensitize endocrinologists to possible false positive values of CgA in order to prevent expensive diagnostic work-up in searching for NETs. SUBJECTS AND METHODS: Thirty-five female and nine male in-patients (18-81 years) were studied. Mild or severe hypertension in 20 patients needed therapy. Endocrine and metabolic diseases were diagnosed in the majority of patients. CgA levels were evaluated before and during OM therapy (10 mg/day, orally). RESULTS: Without OM therapy, CgA levels were 64+/-6 microg/l. Elevated baseline CgA levels were found in nine subjects. CgA levels were significantly related to age (P<0.001), creatinine levels (P=0.03) and the severity of hypertension (P=0.002). On short-term OM therapy (n=42; 18.8+/-2.4 days; range 5-90 days) a significant (P<0.001) increase in CgA (145+/-22 microg/l) from baseline (63+/-7 microg/l) levels was found. The average net CgA increase on short-term OM therapy was 93+/-20 microg/l. There was a significant correlation between baseline CgA levels and CgA increase on short-term OM therapy (P=0.004) but not between the increase in CgA and the duration of the therapy. CONCLUSIONS: An increase in CgA levels quickly follows the start of low dosages of OM. This release is more pronounced when the baseline CgA levels are already increased by slight renal insufficiency or severe hypertension. In this common clinical situation an intensive work-up for NETs is not justified before reassessment of CgA after the withdrawal of OM.

Adolescent↗