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Biomedical subjects

G H Hartung

Publications and source records attributed to G H Hartung.

At least 19 recordsLinked to original sources
PubMed2001

Interdisciplinary treatment of diabetes mellitus in a military treatment facility.

The American Diabetes Association emphasizes interdisciplinary management as the standard of care for patients with diabetes. Many times, however, interdisciplinary means various health care professionals treating a patient but not necessarily interacting with each other regarding the patient's care. Recently, Tripler Army Medical Center replicated the Joslin Diabetes Center's diabetes outpatient intensive treatment program as part of a Joslin Diabetes Center/Department of Defense/Veteran's Administration research collaboration. Tripler Army Medical Center named this interdisciplinary program Holopono, which is Hawaiian for success. Holopono is a team of health care professionals providing integrated care and education to a group of diabetes patients over 3.5 days. Individual care management, aided by an Internet-based telemedicine system, then continues for 1 year after entry into the program. This article describes the Holopono program, the role of each team member, and how the team functions together to provide comprehensive diabetes care.

Comprehensive Health Care↗
PubMed1995

Estimation of aerobic capacity from submaximal cycle ergometry in women.

Simple, valid, and reliable methods of estimating maximal oxygen uptake (VO2max) are needed for epidemiologic studies of physical activity, to evaluate fitness for job performance, and to assist in prescription of exercise. Such estimations in women have not received due research attention. Heart rate responses to submaximal cycle ergometry and VO2max during maximal treadmill and cycle ergometer testing were measured in 37 healthy women aged 19-47 yr (X = 31.7 +/- 7.9). The submaximal test was very reliable on retest (r = 0.92), but overestimated measured treadmill VO2max (X = 2.42 vs 2.23 l.min-1; r = 0.76, SEE = 0.229). The submaximal test also greatly overestimated maximal cycle ergometer VO2max (X = 2.42 vs 2.06 l.min-1; r = 0.70, SEE = 0.340). Similar 8.5% (treadmill) and 18.5% (cycle ergometer) overestimation by the submaximal test were found for VO2max relative to body weight. A simple submaximal exercise test is highly reliable as an estimate of VO2max when used for women. It also provides a reasonably good estimate of treadmill measured VO2max.

Adult↗
PubMed1993

Comparison of treadmill exercise testing protocols for wheelchair users.

The reduced early mortality and the increased life span of persons with spinal cord injury (SCI) and other chronically disabling conditions which result in loss of use of the legs places them at increased risk of coronary heart disease, diabetes, and hypertension. Exercise testing in this population is becoming more common, but there is a need for assessment of protocols in order to determine the best method to elicit a maximal response in a reasonable time without endangering the patient. Three wheelchair treadmill protocols were compared in seven men with paraplegia aged 21-44 years (five SCI, two post-polio). Subjects repeated each protocol to estimate reliability. Protocol G consisted of increasing treadmill grade at a constant speed (4.8 km.h-1); in protocol S, the speed was increased at a constant grade (0%), and in protocol C, speed and grade were increased. Two-minute stages were used in all protocols. Peak oxygen uptake [VO2max; mean (SD): 23.6 (5.8) ml.kg-1 x min-1; 1.66 (0.37) l.min-1], VCO2 production [1.98 (0.46) l.min-1], ventilation volume [83.0 (25.6) l.min-1], respiratory exchange ratio [1.2 (0.12)], and heart rate [173 (18)] were determined. Over all trials none of the variables was significantly different among the three protocols, but all were highest in C and lowest in S. Reliability coefficients for absolute and relative VO2max ranged from 0.76 and 0.81 in G to 0.95 and 0.98 in C (all P < 0.05). These data suggest that an incremental treadmill test similar to the C protocol may be the optimal method to use when evaluating the exercise capacity of wheelchair users.

Adult↗
PubMed1993

Effect of alcohol and exercise on postprandial lipemia and triglyceride clearance in men.

Alcohol intake and exercise have both been found to be related to increased plasma levels of high density lipoprotein cholesterol (HDLC). Exercise training results in decreased postprandial lipemia, and clearance rate of infused lipids is related to plasma lipoprotein levels in physically active men. The effect of alcohol intake on plasma triglyceride (TG) clearance has not been studied in relation to the exercise status of subjects. Plasma TG change over 8 h was determined following a liquid fatty meal in 14 male habitual runners (R) and 13 physically inactive men (I) after 3 weeks of alcohol abstinence and 3 weeks of drinking approximately 41 g (1.44 oz) of ethanol per day. Fasting total cholesterol and apolipoprotein A-1 (apo A-1) were not different between groups, but TG was lower and HDLC, HDL2C, and HDL3C were higher in the runners. After abstinence, I had slower TG clearance (P = 0.07) compared with R; with alcohol, TG clearance was unchanged in R, but was significantly retarded in I. With alcohol, both groups had increased HDLC levels, but this mainly was due to an increase in HDL3C in R and HDL2C in I; apo A-1 increased similarly in both groups and fasting TG increased significantly only in I. Alcohol-induced increases in postprandial lipemia and retardation of TG clearance appear to occur in inactive, but not exercise-trained subjects and the effect of alcohol on plasma HDL subfractions may differ between these groups.

Adult↗
PubMed1993

Prediction of maximal oxygen uptake from submaximal exercise testing in aerobically fit and nonfit men.

Aerobic physical fitness, as determined by the body's maximal capacity to utilize oxygen (VO2max) during demanding work, is an important determinant of a person's ability to perform many military tasks. The present 2.4 km (1.5 mi) run has not proven itself capable of accurately estimating this important factor on a periodic basis. This paper reviews prior studies of heart rate response to known workloads on a cycle ergometer to estimate VO2max. This submaximal test, as revised by scientists at the USAF Armstrong Laboratory at Brooks AFB, TX, was validated on 22 male subjects by comparing the test results with laboratory measurements of VO2max obtained by analysis of expired air during maximal treadmill exercise. Two groups of subjects were selected; one consisting of highly trained runners and the other of inactive subjects who did not perform regular aerobic exercise. The cycle ergometry prediction underestimated measured VO2max by 8.1 ml.kg-1 x min-1 (SEE = 4.25) in all subjects, but there was a correlation of 0.95 between the estimated and measured values. Both estimated and measured VO2max were significantly higher in the group of trained runners than in the inactive subjects.

Adolescent↗
PubMed1992

Influence of post-exercise activity on plasma catecholamines, blood pressure and heart rate in normal subjects.

The purpose of this study was to evaluate whether or not the type of activity performed during recovery might influence the magnitude of catecholamine outflow following exercise. Six active, male volunteers between 40-52 years recovered from strenuous treadmill exercise in three different ways; standing, supine rest and walking (2 mph, 0% grade). Measurements of noradrenaline (NA), adrenaline (A), heart rate and blood pressure were made at rest, peak exercise, and at 30 s intervals through 5-min of recovery. Peak exercise NA concentrations were approximately 1000% above those recorded as rest. Early recovery was marked by a continued increase in NA from peak exercise concentrations (4614 +/- 548 vs. 3264 +/- 485 pg/ml) which did not return to peak exercise levels until approximately 90 s of recovery. Adrenaline responses followed similar trends; however, the changes were not as sizable. Heart rate and diastolic blood pressure were significantly affected by the post-exercise condition; supine recovery produced significantly lower mean heart rates and mean diastolic blood pressures in comparison to standing or continued walking recovery conditions. Thus, these data indicate no specific recovery strategy will stem the rise in exercise-induced plasma catecholamines. Clinically, a strategy of continued walking, or better, supine recovery will best meet special clinical requirements, as well as limit the magnitude of the peak catecholamine increases.

Adult↗
PubMed1990

Effect of alcohol dose on plasma lipoprotein subfractions and lipolytic enzyme activity in active and inactive men.

Controversy as to which lipoprotein subfraction of high-density lipoprotein (HDL) increases during alcohol consumption prompted the current study of the effects of two alcohol doses over varying time intervals on plasma lipoproteins and lipolytic enzymes. Measurements were made in 49 healthy men before and after three weeks of abstinence from alcohol and after consumption of one or three 12-ounce cans of beer per day. We found that HDL (10%), HDL2 (14%), and HDL3 (9%) cholesterol, and apolipoprotein A-I (7%) decreased with abstinence from alcohol and then increased with its consumption. These increases were not significant until after 3 weeks of daily alcohol intake, but they were significant in both the one-can and three-cans of beer per day groups. In the 23 inactive subjects HDL and HDL2 cholesterol decreased with abstinence but did not increase significantly with alcohol intake. Lipolytic enzymes were not changed by alcohol manipulation, but the level of lipoprotein lipase was higher and that of hepatic lipase was lower at each measurement point in the 26 habitually active versus the 23 inactive subjects. Adjustment for weight or skinfold thickness did not affect lipoprotein changes over time within groups but did eliminate many of the differences between activity groups. Alcohol consumption seems to be related to possibly beneficial influences on plasma HDL and HDL2 cholesterol, and may thus impact the risk of heart disease.

Adult↗
PubMed1990

Exercise tolerance and alcohol intake. Blood pressure relation.

The relations of systolic and diastolic blood pressures to alcohol intake and exercise tolerance levels in 15,612 men and 3,855 women were investigated. Alcohol intake was assessed by questionnaire and stratified into seven levels for men and six for women according to the ounces of ethanol consumed per week. Exercise tolerance was determined by maximal treadmill exercise testing and was categorized into six age-specific by sex-specific levels. Both systolic and diastolic blood pressure were significantly related to both alcohol intake and exercise tolerance levels in both men and women. These relations, which were positive for alcohol and negative for exercise tolerance, remained after covariance adjustment for age, body mass index, and cigarette smoking. Alcohol intake was not significantly correlated with exercise tolerance. The relation of blood pressure to alcohol was not linear because the blood pressure of moderate consumers of alcohol tended to be slightly lower than that of nondrinkers. Higher blood pressure was found only in drinkers whose ethanol intake exceeded 9.5 ounces (approximately 285 ml or 19 drinks) per week. However, heavy drinkers in high exercise tolerance categories had no higher blood pressure than nondrinkers in low exercise tolerance groups. Exercise tolerance or physiological fitness appears to be important in quantifying the relation between alcohol intake and blood pressure and should be considered in describing this relation.

Adolescent↗
PubMed1990

Epidemiology of ocean sports-related injuries in Hawaii: 'Akahele O Ke Kai'.

Before attempting to prevent ocean activity injuries, as well as to improve treatment strategies, more information is needed regarding the numbers of injuries that are geographic and activity specific and the identification of persons at risk for such injury. Data on 276 injuries that occurred during ocean sports activities on the islands of Oahu and Hawaii over a 10-month period are presented. The injuries were mainly related to swimming and board-surfing, although serious injuries were found for almost all types of sports activities. The majority of those injured were young adult men who were local residents. Over 10% of the injuries required hospitalization, including 4 fatalities due to drowning and 5 spinal cord injuries due to trauma or to SCUBA-related, decompression incidents. Our study identifies the need for determining an estimate of the number of persons engaging in ocean sports, establishes the need for a single reporting system for injuries, determines potential risk factors, and suggests targets for prevention.

Athletic Injuries↗
PubMed1987

Hormone and energy substrate changes during prolonged exercise in the heat.

Eleven trained men (aged 34.5 +/- 2 yrs) were studied during a 16.1 km run in the heat (Ta = 30.2 degrees C). Fasting blood samples were taken prior to the run and at 6.4, 12.9, and 16.1 km, and 3 h recovery. Serum or plasma glucose, insulin, glucagon, glycerol, and catecholamines were measured. Mean values were: exercise intensity, 80% of VO2max; final rectal temperature, 39.9 degrees C; and weight loss, 4.0%. Glucose increased 61% by 6.4 km, then decreased significantly by 16.1 km. Glycerol increased by 415% at 6.4 km, and continued to increase throughout the run. Epinephrine increased progressively during the run, but norepinephrine increased at 6.4 km, and did not change further during the exercise. Insulin increased slightly at 6.4 km, then decreased significantly from 6.4-16.1 km. Glucagon increased from 6.4-12.9 km and remained elevated at 3 h recovery. Hormone and substrate measurements obtained only before and after prolonged exercise may not reflect changes that occur during the course of the exercise. The observed insulin-glucagon relationships vary from previous findings in nontrained subjects at lower exercise intensities.

Adult↗
PubMed1986

Effect of alcohol intake and exercise on plasma high-density lipoprotein cholesterol subfractions and apolipoprotein A-I in women.

Abstinence from alcohol consumption for 3 weeks was followed by 3 weeks of wine intake in 18 inactive and 18 physically active premenopausal women (runners). The runners weighed less and had higher plasma high-density lipoprotein (HDL) cholesterol and lower low-density lipoprotein cholesterol levels than the inactive women. There were no differences between groups in plasma total cholesterol, triglyceride and apolipoprotein A-I concentrations. Runners had higher plasma HDL2 cholesterol concentrations than inactive women (34 +/- 17 vs 19 +/- 12 mg/dl), but HDL3 cholesterol concentration did not differ between the groups (41 +/- 10 vs 39 +/- 9 mg/dl). Addition of 35 g/day of ethanol for 3 weeks did not result in a significant change in either group for any of the variables measured. The amount of exercise appears to be a more important determinant of plasma lipoproteins and apolipoprotein A-I than alcohol intake in premenopausal women.

Adult↗
PubMed1986

Effect of short-term energy intake level and exercise on oxygen consumption in men.

The influence of short-term energy intake and cycle exercise on oxygen consumption in response to a 1.5 MJ test meal was investigated in ten young, adult men. On the morning after a previous day's "low-energy" intake (LE regimen) of 4.5 MJ, the mean resting oxygen consumption increased by 0.7 ml X kg-1 X min-1 after the test meal (P less than 0.025). After a "high-energy" intake (HE regimen) of 18.1 MJ, the resting measurement was unchanged (+0.4 ml X kg-1 X min-1) after the meal (n.s.). These trends are the reverse of what would be expected if oxygen consumption in response to feeding is a factor in the acute control of body weight. The mean fasting oxygen consumption during cycle exercise at 56% of VO2max (constant work) for both LE and HE prior intakes was not different at 31.1 ml X kg-1 X min-1. Oxygen consumption during exercise increased after feeding by 0.5 ml X kg-1 X min-1 on the LE regimen (n.s.) and decreased by 1.2 ml X kg-1 X min-1 on the HE regimen (n.s.). These results are also the reverse of what would be expected if oxygen consumption in response to exercise is related to short-term energy intake.

Body Weight↗
PubMed1986

Accuracy of measured and predicted residual lung volume on body density measurement.

The effects of measured and predicted residual lung volume on the accuracy of body density and percent fat (%Fat) were investigated. Adult fitness subjects (N = 46) had residual lung volume measured with the oxygen dilution method while those from an athlete sample (N = 134) utilized the nitrogen washout technique. Residual lung volume was also predicted with gender-specific regression equations using height and age and from 24% of vital capacity (%FVC). Residual lung volume alpha reliability for the average of four residual lung volume trials exceeded 0.90 (SEM less than = 161 ml) for the oxygen dilution method and 0.99 (SEM = 30 ml) for the average of two nitrogen washout measures. The standard errors for predicted residual lung volume were 579 and 355 ml, respectively, for the men and women in the adult sample and 288 ml for the trained athlete sample. Estimating residual lung volume from %FVC yielded a SEE of 318 ml for the trained athlete sample. Measured residual lung volume errors resulted in errors of 1.04%Fat, 0.87%Fat, and 0.21%Fat for the men, women, and trained athlete samples, respectively. In contrast, predicted residual lung volume measurement errors resulted in errors of 3.70%Fat, 2.85%Fat, and 1.98%Fat for the respective samples and 2.18%Fat when using %FVC with the trained athletes. Measured residual lung volume introduces little %Fat error while predicted residual lung volume introduces a substantial source of measurement error.

Adipose Tissue↗
PubMed1985

Plasma volume changes in middle-aged male and female subjects during marathon running.

Circulatory fluid shifts were studied in middle-aged runners (6 males and 5 females, ages 32-58 yr) during a 42.2-km marathon race run in mild weather (dry-bulb temperature = 17.5-20.4 degrees C). Running times for the subjects were 3:12-4:40 (mean values were 3:34 for males and 4:10 for females). Venous blood samples were taken without stasis in all subjects seated at rest before the start of the race and within 3 min of finishing; eight of the subjects also paused for samples at 6 and 27 km during the race. At 6 km, body weight loss averaged less than 1%, whereas plasma volume (PV) had decreased by 6.5% in male subjects and 8.6% in female subjects. By the end of the race, hypohydration had reached 3.2% in male subjects and 2.9% in female subjects, but PV in both groups remained stable. Sweat rates during the race averaged 545 and 429 g X m-2 X h-1 for male and female subjects, respectively, with ad lib. water intake replacing 21-72% of fluid loss. Increases in plasma protein concentration throughout the race reflected the observed initial decrease in PV. The interpretation of PV responses to exercise and/or hypohydration is critically dependent on selection of base-line conditions; we were able to control for posture-exercise effects by treating the early exercise (6 km) sample as the base line for examining the effects of later fluid loss. Under these conditions, the vascular compartment resisted volume depletion. The ability to maintain stable PV can be explained in part by relationships among oncotic and hydrostatic pressures in the intra- and extravascular fluid compartments.

Adult↗
PubMed1984

Hemodynamic effects of oral smokeless tobacco in dogs and young adults.

Oral smokeless tobacco (snuff) is increasingly used among the young male population. To determine cardiovascular effects of an oral smokeless tobacco product, 10 anesthetized dogs were instrumented to measure blood pressure, heart rate, left ventricular end diastolic pressure, and circumflex coronary, renal, and femoral flows. After a 5-min baseline, a 2.5-g, approximately 1.2% nicotine bolus dose was placed in the buccal space, and measurements were made for 20 min. Significant increases were seen in heart rate, blood pressure, left ventricular pressure, left ventricular end diastolic pressure, and left ventricular dP/dt. Significant decreases in flow were noted in the coronary circumflex, renal, and femoral arteries. The flow reduction was thought to have been mediated by an alpha-adrenergic mechanism. Additionally, 20 human males, mean age 20 years, without nicotine exposure for 72 hr, were given a 2.5-g dose of the same oral smokeless product. From baseline to 20 min, heart rate increased from 69 to 88 beats/min (P less than 0.05), blood pressure from 118/72 to 126/78 mm Hg (P less than 0.05). Thus, oral smokeless tobacco use can produce significant hemodynamic changes in both dogs and normal humans.

Administration, Oral↗
PubMed1984

Plasma substrate response in men and women during marathon running.

Venous blood samples from three male and four female subjects were taken in conjunction with a 26.2-mi marathon race prior to the start (control), at 17 mi, and immediately after the finish. Plasma concentrations of glucose and free fatty acids (FFA) were determined, and the ratio of unsaturated to saturated FFA (U/S FFA) was calculated. Compared to the control value, glucose was unchanged at the finish despite a slight increase at 17 mi (not significant). FFA increased significantly (p less than 0.05) from control to finish and from 17 mi to finish in both groups. The U/S FFA ratio also increased progressively from control to finish. No significant differences were found between male and female groups for any of the measured values. We conclude that blood glucose is maintained at normal levels during prolonged heavy exercise in trained women as in men, and that FFA availability increases with time during strenuous exercise in both sexes.

Adult↗
PubMed1983

Effect of alcohol intake on high-density lipoprotein cholesterol levels in runners and inactive men.

Plasma high-density lipoprotein cholesterol (HDLC) level was measured before and after alcohol abstinence and after resumption of a controlled alcohol dose in 16 marathon runners, 15 joggers, and 13 inactive men. A three-week period of abstinence resulted in a significant decrease in HDLC concentration in the inactive men (49.8 to 41.8 mg/dL). Three weeks of alcohol consumption (1,065 mL of beer per day) produced a significant increase in HDLC level to 50.9 mg/dL. No change in HDLC level was found for the marathon group or the joggers during abstinence or three weeks of alcohol intake. The consumption of alcohol in moderation seems to be associated with increased HDLC levels in inactive men but not in men who engage in regular running or jogging.

Adult↗