Background and Objectives: Cortisol is a valuable marker for assessing the body’s response to any... more Background and Objectives: Cortisol is a valuable marker for assessing the body’s response to any form of stress. We conducted this study in order to evaluate the variations of salivary and serum cortisol levels in professional football players in relation to cardiopulmonary exercise testing (CPET) and their significance in potentially evaluating overtraining in athletes. Also, the question of whether salivary cortisol determination could fully substitute serum sampling was addressed. Materials and Methods: A total of 19 male professional football players were evaluated by measuring serum cortisol levels at rest (T0) and immediately after a CPET (T1) and salivary cortisol levels at rest (T0), 10 min after a CPET (T2), and 30 min after a CPET (T3). Results: T0 serum cortisol showed a statistically significant correlation with the oxygen uptake at the anaerobic threshold divided by the body weight (VO2-AT/weight), as did the T2 salivary cortisol with the maximum oxygen uptake at the a...
Cardiovascular rehabilitation represents a very important measure in post myocardial infarction p... more Cardiovascular rehabilitation represents a very important measure in post myocardial infarction patients for both, improving their quality of life and preventing other acute cardiovascular events. It is important to accurately assess functional capacity of patients after acute coronary events, in order to optimize the results of cardiac rehabilitation program. Cardiopulmonary exercise testing (CPET) represents the gold standard in functional capacity assessment. We present 3 clinical cases of post STEMI patients, with coronary revascularization interventions, addressed to cardiovascular rehabilitation. They underwent CPET evaluation at baseline and during rehabilitation program. This method proved important utility for individualization of cardiovascular rehabilitation program, as well as for monitoring the long term evolution after myocardial infarction.
Chronic diseases result in an enormous burden of morbidity and mortality worldwide, projected to ... more Chronic diseases result in an enormous burden of morbidity and mortality worldwide, projected to continuously increase over the next decades. Cardio-vascular diseases, followed by cancers, chronic respiratory diseases and diabetes mellitus, represent the main causes of death caused by chronic conditions. The majority of chronic diseases are multifactor disorders, the main etiological role being played by various behavioral or environmental risk factors. Social factors such as education, employment status, income, familial and social stress have also a major role in determining chronic diseases, both directly and indirectly, by increasing the susceptibility to behavioral risk factors. Chronic pathology results in chronic symptoms which dramatically impairs the patient quality of life and working capacity, also resulting in a significant social and economic burden. Social problems develop with the progressive exercise capacity alteration, resulting in limited mobility, home-bounding, ...
Introduction: Acute pulmonary embolism (APE) is a life threatening disease and one of the main ca... more Introduction: Acute pulmonary embolism (APE) is a life threatening disease and one of the main causes of in-hospital mortality. Hyperglycemia secondary to diabetes mellitus, impaired glucose tolerance or stress-induced, occurs frequently in critically ill patients and is associated with adverse outcome. The relationship between hyperglycemia and outcome in APE patients has not been clearly defined. Aim: The purpose of the study was to determine the association between hyperglycemia and risk - adjusted mortality in APE patients. Methods: We conducted a prospective, cohort study, between 1 January 2004 and 31 December 2009. The patients with APE, admitted in the Ist Medical Cardiology Clinic, in “St Spiridon” University Hospital, Iasi were included. Hyperglycemia was defined as an admission or in-hospital fasting glucose level of 126 mg/dl (7 mmol/liter) or more or a random blood glucose level of 200 mg/dl (11.1 mmol/liter) or more on 2 or more determinations. Results: During the study period, we enrolled 326 patients with APE. Mean age of the patients was 62.3 years (range 16 - 95 years), 197 (60%) were females, 30 (9%) were in shock at admission and 36 (11.04%) had diabetes mellitus diagnosis before admission. Fifty seven patients died during hospital stay (17%). Multivariable analysis showed that hyperglycemia was an independent predictor for in-hospital mortality in APE patients (p Conclusion: Hyperglycemia is an independent predictor for in-hospital mortality in APE.
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
In chronic obstructive pulmonary disease (COPD) the changes in respiratory thoracoabdominal mecha... more In chronic obstructive pulmonary disease (COPD) the changes in respiratory thoracoabdominal mechanics result from both hyperinflation and functional and structural skeletal muscle alterations. Evaluation of the particularities of respiratory movement in COPD and identification of inter-relations between respiratory thoraco-abdominal mechanics and clinical and functional respiratory status. This study comparatively analyzed the respiratory thoracoabdominal mechanics recorded by polygraphy, using piezoelectric film belts, in 34 COPD patients and 30 healthy subjects, during rest, and during 6-minute walk test. In COPD patients, phase angle between direction of thoracic and abdominal respiratory movements presented significantly higher values compared to the control group, for supine (p = 0.023) and sitting position (p = 0.001), revealing the presence of paradoxical respiratory movements. Furthermore, phase angle dynamics increased significantly during walking test compared to sitting p...
Autonomic nervous system dysfunction proved in chronic obstructive pulmonary disease (COPD) patie... more Autonomic nervous system dysfunction proved in chronic obstructive pulmonary disease (COPD) patients might determine an elevated cardiovascular risk by heart rate alteration. To assess the particularities of heart rate as a possible cardiovascular risk factor in COPD patients. This prospective, case-control study comparatively analyzed the pulse rate continuously recorded with a polygraph in 32 COPD patients and 29 healthy subjects during rest (supine and sitting position) and during submaximal exercise (6-minute walk test). The relation between pulse rate and respiratory, functional or clinical alterations was analyzed in COPD patients. The mean pulse rate was significantly higher during rest and exercise in COPD patients compared with the controls. However, the chronotropic response determined by exercise was similar in COPD and control groups: 55.19 beats/minute and 57.21 beats/minute, respectively (p=0.686). The mean pulse rate during exercise correlated with hypoxemia (r=-0.354...
Pulmonary embolism is a life threatening disease and one of the main causes of in-hospital mortal... more Pulmonary embolism is a life threatening disease and one of the main causes of in-hospital mortality. There are multiple risk stratification scoring systems for the forecast of the outcomes in patients with pulmonary embolism. We conducted a prospective observational cohort study to evaluate the comparative validity of four prognostic models: pulmonary embolism severity index (PESI), simplified PESI score, PESI risk classes and shock index, for predicting short-term mortality in acute pulmonary embolism. The PESI and PESI--simplified scores and shock-index were calculated. PESI scores were segregated into risk class (I-V) obtaining PESI classes. Shock index was dichotomized into 0 (for value < 1) versus 1 (for value > 1) risk groups. We determined the area under Receiver Operating Characteristic curve, the sensitivity, specificity, likelihood ratio (LR+, LR-) for PESI score, simplified PESI score, PESI risk classes and shock index, to compare the ability of these scoring tools...
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
Pulmonary venous thromboembolism and atherothrombosis are traditionally considered as distinct di... more Pulmonary venous thromboembolism and atherothrombosis are traditionally considered as distinct diseases. As the two entities share common risk factors and mechanisms current experimental and clinical studies support their mutual causal relationship. For the clinician, the current concept requires a different clinical, laboratory and therapeutic approach. The patient with a first arterial or venous thrombosis should be fully assessed for the risk of future clinical events, and, simultaneously addressed to aggressive preventive non-pharmacological and pharmacotherapy intervention. In this context, antiplatelet agents and statins have a potentially beneficial role.
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
Autonomic nervous system dysfunction proved in chronic obstructive pulmonary disease (COPD) patie... more Autonomic nervous system dysfunction proved in chronic obstructive pulmonary disease (COPD) patients might determine an elevated cardiovascular risk by heart rate alteration. To assess the particularities of heart rate as a possible cardiovascular risk factor in COPD patients. This prospective, case-control study comparatively analyzed the pulse rate continuously recorded with a polygraph in 32 COPD patients and 29 healthy subjects during rest (supine and sitting position) and during submaximal exercise (6-minute walk test). The relation between pulse rate and respiratory, functional or clinical alterations was analyzed in COPD patients. The mean pulse rate was significantly higher during rest and exercise in COPD patients compared with the controls. However, the chronotropic response determined by exercise was similar in COPD and control groups: 55.19 beats/minute and 57.21 beats/minute, respectively (p=0.686). The mean pulse rate during exercise correlated with hypoxemia (r=-0.354...
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
Chronic Obstructive Pulmonary Disease (COPD) is an important public health challenge, representin... more Chronic Obstructive Pulmonary Disease (COPD) is an important public health challenge, representing the fourth leading cause of death in the world. A very important characteristic of COPD is represented by the coexistence of comorbidities. Lung cancer, a major cause of morbidity and mortality throughout the world, is also a frequent comorbidity in COPD. Cigarette smoking represents the best-known risk factor in both COPD and lung cancer, causing common pathogenic mechanisms like oxidative stress and inflammation. However, the etiopathogenic link between COPD and lung cancer implies a common underlying genetic susceptibility, acting in addition to environmental risk factors. These trigger more complex cellular and molecular mechanisms, represented by immune dysfunction, abnormal activation of transcription factors, altered signaling pathways, epithelial to mesenchymal transition. A better understanding of the etiopathogenic link between COPD and lung cancer at the molecular level will...
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
Pulmonary embolism is a life threatening disease and one of the main causes of in-hospital mortal... more Pulmonary embolism is a life threatening disease and one of the main causes of in-hospital mortality. There are multiple risk stratification scoring systems for the forecast of the outcomes in patients with pulmonary embolism. We conducted a prospective observational cohort study to evaluate the comparative validity of four prognostic models: pulmonary embolism severity index (PESI), simplified PESI score, PESI risk classes and shock index, for predicting short-term mortality in acute pulmonary embolism. The PESI and PESI--simplified scores and shock-index were calculated. PESI scores were segregated into risk class (I-V) obtaining PESI classes. Shock index was dichotomized into 0 (for value < 1) versus 1 (for value > 1) risk groups. We determined the area under Receiver Operating Characteristic curve, the sensitivity, specificity, likelihood ratio (LR+, LR-) for PESI score, simplified PESI score, PESI risk classes and shock index, to compare the ability of these scoring tools...
RISK (Abstract): BACKGROUND: Accurate and immediate diagnosis of venous thromboembolism (VTE) sti... more RISK (Abstract): BACKGROUND: Accurate and immediate diagnosis of venous thromboembolism (VTE) still remains a difficult challenge for clinicians. Without prophylaxis, the incidence of hospital-acquired VTE is approximately 10-40% among surgical patients ...
Chronic diseases result in an enormous burden of morbidity and mortality worldwide, projected to ... more Chronic diseases result in an enormous burden of morbidity and mortality worldwide, projected to continuously increase over the next decades. Cardiovascular diseases, followed by cancers, chronic respiratory diseases and diabetes mellitus, represent the main causes of death caused by chronic conditions. The majority of chronic diseases are multifactor disorders, the main etiological role being played by various behavioral or environmental risk factors. Social factors such as education, employment status, income, familial and social stress have also a major role in determining chronic diseases, both directly and indirectly, by increasing the susceptibility to behavioral risk factors. Chronic pathology results in chronic symptoms which dramatically impairs the patient quality of life and working capacity, also resulting in a significant social and economic burden. Social problems develop with the progressive exercise capacity alteration, resulting in limited mobility, home-bounding, s...
Abstract : Pilot ability to fly holding patterns utilizing various navigational techniques and re... more Abstract : Pilot ability to fly holding patterns utilizing various navigational techniques and readouts including use of pictorial displays was determined. The terminal area approach and the holding pattern were emphasized as part of a program also involving en route and high-altitude utilization of pictorial displays. The investigation provided information based on the pilot's ability to use pictorial displays as compared to the pilot's ability to use standard navigation panel displays. The tests were conducted using commissioned ground facilities for approaches to terminal areas employing normal ground-to-air-toground controller/pilot communications, including clearances to reporting fixes, holding fixes, and airport approaches. The results, based on recordings obtained using an AN/MSQ-1 tracking radar, indicate no significant difference between a pilot's ability to navigate in an approach area using a pictorial display, and his ability to navigate using standard panel instruments, dual VOR and VOR/DME techniques. (Author)
Background and Objectives: Cortisol is a valuable marker for assessing the body’s response to any... more Background and Objectives: Cortisol is a valuable marker for assessing the body’s response to any form of stress. We conducted this study in order to evaluate the variations of salivary and serum cortisol levels in professional football players in relation to cardiopulmonary exercise testing (CPET) and their significance in potentially evaluating overtraining in athletes. Also, the question of whether salivary cortisol determination could fully substitute serum sampling was addressed. Materials and Methods: A total of 19 male professional football players were evaluated by measuring serum cortisol levels at rest (T0) and immediately after a CPET (T1) and salivary cortisol levels at rest (T0), 10 min after a CPET (T2), and 30 min after a CPET (T3). Results: T0 serum cortisol showed a statistically significant correlation with the oxygen uptake at the anaerobic threshold divided by the body weight (VO2-AT/weight), as did the T2 salivary cortisol with the maximum oxygen uptake at the a...
Cardiovascular rehabilitation represents a very important measure in post myocardial infarction p... more Cardiovascular rehabilitation represents a very important measure in post myocardial infarction patients for both, improving their quality of life and preventing other acute cardiovascular events. It is important to accurately assess functional capacity of patients after acute coronary events, in order to optimize the results of cardiac rehabilitation program. Cardiopulmonary exercise testing (CPET) represents the gold standard in functional capacity assessment. We present 3 clinical cases of post STEMI patients, with coronary revascularization interventions, addressed to cardiovascular rehabilitation. They underwent CPET evaluation at baseline and during rehabilitation program. This method proved important utility for individualization of cardiovascular rehabilitation program, as well as for monitoring the long term evolution after myocardial infarction.
Chronic diseases result in an enormous burden of morbidity and mortality worldwide, projected to ... more Chronic diseases result in an enormous burden of morbidity and mortality worldwide, projected to continuously increase over the next decades. Cardio-vascular diseases, followed by cancers, chronic respiratory diseases and diabetes mellitus, represent the main causes of death caused by chronic conditions. The majority of chronic diseases are multifactor disorders, the main etiological role being played by various behavioral or environmental risk factors. Social factors such as education, employment status, income, familial and social stress have also a major role in determining chronic diseases, both directly and indirectly, by increasing the susceptibility to behavioral risk factors. Chronic pathology results in chronic symptoms which dramatically impairs the patient quality of life and working capacity, also resulting in a significant social and economic burden. Social problems develop with the progressive exercise capacity alteration, resulting in limited mobility, home-bounding, ...
Introduction: Acute pulmonary embolism (APE) is a life threatening disease and one of the main ca... more Introduction: Acute pulmonary embolism (APE) is a life threatening disease and one of the main causes of in-hospital mortality. Hyperglycemia secondary to diabetes mellitus, impaired glucose tolerance or stress-induced, occurs frequently in critically ill patients and is associated with adverse outcome. The relationship between hyperglycemia and outcome in APE patients has not been clearly defined. Aim: The purpose of the study was to determine the association between hyperglycemia and risk - adjusted mortality in APE patients. Methods: We conducted a prospective, cohort study, between 1 January 2004 and 31 December 2009. The patients with APE, admitted in the Ist Medical Cardiology Clinic, in “St Spiridon” University Hospital, Iasi were included. Hyperglycemia was defined as an admission or in-hospital fasting glucose level of 126 mg/dl (7 mmol/liter) or more or a random blood glucose level of 200 mg/dl (11.1 mmol/liter) or more on 2 or more determinations. Results: During the study period, we enrolled 326 patients with APE. Mean age of the patients was 62.3 years (range 16 - 95 years), 197 (60%) were females, 30 (9%) were in shock at admission and 36 (11.04%) had diabetes mellitus diagnosis before admission. Fifty seven patients died during hospital stay (17%). Multivariable analysis showed that hyperglycemia was an independent predictor for in-hospital mortality in APE patients (p Conclusion: Hyperglycemia is an independent predictor for in-hospital mortality in APE.
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
In chronic obstructive pulmonary disease (COPD) the changes in respiratory thoracoabdominal mecha... more In chronic obstructive pulmonary disease (COPD) the changes in respiratory thoracoabdominal mechanics result from both hyperinflation and functional and structural skeletal muscle alterations. Evaluation of the particularities of respiratory movement in COPD and identification of inter-relations between respiratory thoraco-abdominal mechanics and clinical and functional respiratory status. This study comparatively analyzed the respiratory thoracoabdominal mechanics recorded by polygraphy, using piezoelectric film belts, in 34 COPD patients and 30 healthy subjects, during rest, and during 6-minute walk test. In COPD patients, phase angle between direction of thoracic and abdominal respiratory movements presented significantly higher values compared to the control group, for supine (p = 0.023) and sitting position (p = 0.001), revealing the presence of paradoxical respiratory movements. Furthermore, phase angle dynamics increased significantly during walking test compared to sitting p...
Autonomic nervous system dysfunction proved in chronic obstructive pulmonary disease (COPD) patie... more Autonomic nervous system dysfunction proved in chronic obstructive pulmonary disease (COPD) patients might determine an elevated cardiovascular risk by heart rate alteration. To assess the particularities of heart rate as a possible cardiovascular risk factor in COPD patients. This prospective, case-control study comparatively analyzed the pulse rate continuously recorded with a polygraph in 32 COPD patients and 29 healthy subjects during rest (supine and sitting position) and during submaximal exercise (6-minute walk test). The relation between pulse rate and respiratory, functional or clinical alterations was analyzed in COPD patients. The mean pulse rate was significantly higher during rest and exercise in COPD patients compared with the controls. However, the chronotropic response determined by exercise was similar in COPD and control groups: 55.19 beats/minute and 57.21 beats/minute, respectively (p=0.686). The mean pulse rate during exercise correlated with hypoxemia (r=-0.354...
Pulmonary embolism is a life threatening disease and one of the main causes of in-hospital mortal... more Pulmonary embolism is a life threatening disease and one of the main causes of in-hospital mortality. There are multiple risk stratification scoring systems for the forecast of the outcomes in patients with pulmonary embolism. We conducted a prospective observational cohort study to evaluate the comparative validity of four prognostic models: pulmonary embolism severity index (PESI), simplified PESI score, PESI risk classes and shock index, for predicting short-term mortality in acute pulmonary embolism. The PESI and PESI--simplified scores and shock-index were calculated. PESI scores were segregated into risk class (I-V) obtaining PESI classes. Shock index was dichotomized into 0 (for value < 1) versus 1 (for value > 1) risk groups. We determined the area under Receiver Operating Characteristic curve, the sensitivity, specificity, likelihood ratio (LR+, LR-) for PESI score, simplified PESI score, PESI risk classes and shock index, to compare the ability of these scoring tools...
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
Pulmonary venous thromboembolism and atherothrombosis are traditionally considered as distinct di... more Pulmonary venous thromboembolism and atherothrombosis are traditionally considered as distinct diseases. As the two entities share common risk factors and mechanisms current experimental and clinical studies support their mutual causal relationship. For the clinician, the current concept requires a different clinical, laboratory and therapeutic approach. The patient with a first arterial or venous thrombosis should be fully assessed for the risk of future clinical events, and, simultaneously addressed to aggressive preventive non-pharmacological and pharmacotherapy intervention. In this context, antiplatelet agents and statins have a potentially beneficial role.
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
Autonomic nervous system dysfunction proved in chronic obstructive pulmonary disease (COPD) patie... more Autonomic nervous system dysfunction proved in chronic obstructive pulmonary disease (COPD) patients might determine an elevated cardiovascular risk by heart rate alteration. To assess the particularities of heart rate as a possible cardiovascular risk factor in COPD patients. This prospective, case-control study comparatively analyzed the pulse rate continuously recorded with a polygraph in 32 COPD patients and 29 healthy subjects during rest (supine and sitting position) and during submaximal exercise (6-minute walk test). The relation between pulse rate and respiratory, functional or clinical alterations was analyzed in COPD patients. The mean pulse rate was significantly higher during rest and exercise in COPD patients compared with the controls. However, the chronotropic response determined by exercise was similar in COPD and control groups: 55.19 beats/minute and 57.21 beats/minute, respectively (p=0.686). The mean pulse rate during exercise correlated with hypoxemia (r=-0.354...
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
Chronic Obstructive Pulmonary Disease (COPD) is an important public health challenge, representin... more Chronic Obstructive Pulmonary Disease (COPD) is an important public health challenge, representing the fourth leading cause of death in the world. A very important characteristic of COPD is represented by the coexistence of comorbidities. Lung cancer, a major cause of morbidity and mortality throughout the world, is also a frequent comorbidity in COPD. Cigarette smoking represents the best-known risk factor in both COPD and lung cancer, causing common pathogenic mechanisms like oxidative stress and inflammation. However, the etiopathogenic link between COPD and lung cancer implies a common underlying genetic susceptibility, acting in addition to environmental risk factors. These trigger more complex cellular and molecular mechanisms, represented by immune dysfunction, abnormal activation of transcription factors, altered signaling pathways, epithelial to mesenchymal transition. A better understanding of the etiopathogenic link between COPD and lung cancer at the molecular level will...
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
Pulmonary embolism is a life threatening disease and one of the main causes of in-hospital mortal... more Pulmonary embolism is a life threatening disease and one of the main causes of in-hospital mortality. There are multiple risk stratification scoring systems for the forecast of the outcomes in patients with pulmonary embolism. We conducted a prospective observational cohort study to evaluate the comparative validity of four prognostic models: pulmonary embolism severity index (PESI), simplified PESI score, PESI risk classes and shock index, for predicting short-term mortality in acute pulmonary embolism. The PESI and PESI--simplified scores and shock-index were calculated. PESI scores were segregated into risk class (I-V) obtaining PESI classes. Shock index was dichotomized into 0 (for value < 1) versus 1 (for value > 1) risk groups. We determined the area under Receiver Operating Characteristic curve, the sensitivity, specificity, likelihood ratio (LR+, LR-) for PESI score, simplified PESI score, PESI risk classes and shock index, to compare the ability of these scoring tools...
RISK (Abstract): BACKGROUND: Accurate and immediate diagnosis of venous thromboembolism (VTE) sti... more RISK (Abstract): BACKGROUND: Accurate and immediate diagnosis of venous thromboembolism (VTE) still remains a difficult challenge for clinicians. Without prophylaxis, the incidence of hospital-acquired VTE is approximately 10-40% among surgical patients ...
Chronic diseases result in an enormous burden of morbidity and mortality worldwide, projected to ... more Chronic diseases result in an enormous burden of morbidity and mortality worldwide, projected to continuously increase over the next decades. Cardiovascular diseases, followed by cancers, chronic respiratory diseases and diabetes mellitus, represent the main causes of death caused by chronic conditions. The majority of chronic diseases are multifactor disorders, the main etiological role being played by various behavioral or environmental risk factors. Social factors such as education, employment status, income, familial and social stress have also a major role in determining chronic diseases, both directly and indirectly, by increasing the susceptibility to behavioral risk factors. Chronic pathology results in chronic symptoms which dramatically impairs the patient quality of life and working capacity, also resulting in a significant social and economic burden. Social problems develop with the progressive exercise capacity alteration, resulting in limited mobility, home-bounding, s...
Abstract : Pilot ability to fly holding patterns utilizing various navigational techniques and re... more Abstract : Pilot ability to fly holding patterns utilizing various navigational techniques and readouts including use of pictorial displays was determined. The terminal area approach and the holding pattern were emphasized as part of a program also involving en route and high-altitude utilization of pictorial displays. The investigation provided information based on the pilot's ability to use pictorial displays as compared to the pilot's ability to use standard navigation panel displays. The tests were conducted using commissioned ground facilities for approaches to terminal areas employing normal ground-to-air-toground controller/pilot communications, including clearances to reporting fixes, holding fixes, and airport approaches. The results, based on recordings obtained using an AN/MSQ-1 tracking radar, indicate no significant difference between a pilot's ability to navigate in an approach area using a pictorial display, and his ability to navigate using standard panel instruments, dual VOR and VOR/DME techniques. (Author)
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